Hepatocellular carcinoma in Africans

Hepatocellular carcinoma is endemic in Africa, where in the incidence of the disease in males ranges from 20-100,000 per annum. The tumor tends to occur at a younger age compared to the age of presentation in Europeans or Chinese. The majority of African patients with HCC are HBsAg positive, but HBsAg is more commonly detected in younger vs older patients. Approximately 30% of patients are anti-HCV positive. Both these chronic virus infections may induce disease via the development of cirrhosis. Other environmental factors including carcinogens such as aflatoxin may act as co-factors. Resection rates for hepatocellular carcinoma are low in this population group, and screening for small tumours is not generally undertaken in Africa.