**Question:** The following are true about Hepatocellular carcinoma except -

A. Hepatocellular carcinoma is the most common type of liver cancer, accounting for over 90% of all liver cancers.
B. It is more common in males than females.
C. The most common cause of Hepatocellular carcinoma is the consumption of alcohol.
D. The disease is exclusively seen in resource-poor countries.

**Correct Answer: C.**

**Core Concept:** Hepatocellular carcinoma (HCC) is a malignant tumor that originates from hepatocytes, the liver's main functional cells. It is a significant global health issue, with ~90% cases being Hepatocellular carcinoma.

**Why the Correct Answer is Right:**
A. Hepatocellular carcinoma is indeed the most common type of liver cancer, with a prevalence of over 90% among all liver cancers. The high incidence is due to various risk factors, such as viral hepatitis (HCV and HBV), non-alcoholic fatty liver disease (NAFLD), and alcohol consumption.
B. While Hepatocellular carcinoma is more common in males, it is not exclusively a gender-specific disease. Both males and females can be affected, although the male-to-female ratio is ~2:1.
D. Hepatocellular carcinoma can occur in both resource-rich and resource-poor countries. However, risk factors such as viral hepatitis, alcohol consumption, and non-alcoholic fatty liver disease are more common in resource-limited regions, contributing to higher incidence rates there.

**Why Each Wrong Option is Incorrect:**
A. While the disease is prevalent in various countries, it is not exclusive to resource-poor settings.
B. Hepatocellular carcinoma is not exclusively associated with alcohol consumption; other risk factors play a significant role as well.
C. Hepatocellular carcinoma is not solely caused by alcohol consumption; viral hepatitis (HCV and HBV) and non-alcoholic fatty liver disease (NAFLD) are significant contributors to the disease.
D. Hepatocellular carcinoma can occur in both resource-rich and resource-poor countries. Risk factors associated with the disease, such as viral hepatitis, alcohol consumption, and non-alcoholic fatty liver disease, can be found in both types of countries.

**Clinical Pearls:**
1. Hepatocellular carcinoma is a critical medical issue affecting millions of individuals worldwide, with a significant impact on public health. Early diagnosis and treatment are crucial for improved prognosis and survival.
2. Risk factors for Hepatocellular carcinoma include viral hepatitis (HCV and HBV), non-alcoholic fatty liver disease (NAFLD), and alcohol consumption. Lifestyle modifications, vaccination, and antiviral therapy can help prevent the development of Hepatocellular carcinoma in patients with these risk factors.