Hepatocellular carcinoma in Egypt: a single center study over a decade

Area of Science:

• Hepatobiliary Medicine
• Gastroenterology
• Oncology Epidemiology

Background:

• Hepatocellular carcinoma (HCC) is a significant global health concern.
• Understanding trends and risk factors for HCC is crucial for public health strategies in Egypt.
• Chronic liver disease (CLD) is a primary precursor to HCC.

Purpose of the Study:

• To analyze the decade-long trends in hepatocellular carcinoma (HCC) incidence in Egypt.
• To identify evolving risk factors, including viral hepatitis and schistosomiasis, associated with HCC.
• To examine changes in the demographic profile and presentation patterns of HCC patients.

Main Methods:

• Retrospective analysis of 1328 HCC patients diagnosed between 1993-2002 at Cairo Liver Center.
• Comparison of HCC characteristics between two 5-year periods (1993-1997 vs. 1998-2002).
• Logistic regression and population attributable risk percentage used to assess risk factors like Hepatitis B virus (HBV) and Hepatitis C virus (HCV).

Main Results:

• The proportion of HCC among CLD patients rose significantly from 4.0% to 7.2% over the decade.
• Hepatitis B surface antigen (HBsAg) prevalence declined, while Hepatitis C virus antibody (HCV-Ab) prevalence slightly increased.
• Earlier detection of smaller HCC lesions (< or = 3 cm) increased, indicating heightened clinical awareness.

Conclusions:

• A near twofold increase in HCC proportion was observed, linked to shifts in HBV and HCV prevalence.
• Hepatocellular carcinoma (HCC) diagnosis showed a trend towards younger age groups and smaller lesion detection.
• Imaging techniques were more effective than alpha-fetoprotein levels for HCC diagnosis, highlighting improved diagnostic capabilities.