34.已知肝細胞癌（hepatocellular carcinoma, HCC）有不同的etiologic factors，且這些factors在不同地區和國 家促成肝癌發生的重要性也不盡相同。以下有關「地區或國家：該地區或國家最重要的etiologic factor of HCC」的組合中，何者正確？
(A)Europe & US：Hepatitis B chronic infection and Wilson's disease
(B)China：Hepatitis C chronic infection and nonalcoholic steatohepatitis
(C)Africa：Aflatoxin B1 and hepatitis B chronic infection
(D)Taiwan：Ethanol chronic consumption and primary biliary cirrhosis

Epidemiology

Asia and sub-Saharan Africa are the areas with the highest incidence of HCC and are also high-risk areas of HBV infection.

HBV and aflatoxin together influence the occurrence of HCC in Africa. It is estimated that aflatoxin B1 is a cofactor in 60% of liver cancer cases in Sudan.

In North America, Europe, and Japan, hepatitis C is the leading cause of liver cancer.

The situation in some countries is as follows:

(A)Europe & US：Hepatitis B chronic infection and Wilson's disease

In North America, Europe, and Japan, hepatitis C is the leading cause of liver cancer.

(B)China：Hepatitis C chronic infection and nonalcoholic steatohepatitis

Asia and sub-Saharan Africa are the areas with the highest incidence of HCC and are also high-risk areas of HBV infection. 
正解(C)Africa：Aflatoxin B1 and hepatitis B chronic infection

HBV and aflatoxin together influence the occurrence of HCC in Africa. It is estimated that aflatoxin B1 is a cofactor in 60% of liver cancer cases in Sudan.

(D)Taiwan：Ethanol chronic consumption and primary biliary cirrhosis

Asia and sub-Saharan Africa are the areas with the highest incidence of HCC and are also high-risk areas of HBV infection.