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Liver cancer in Korea
1Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Yonsei Liver Cancer Special Clinic, Severance Hospital, Seoul, Korea.
Insights
Hepatocellular carcinoma (HCC) is a leading cause of cancer death in Korea, particularly in men. Early detection through screening and surveillance programs is crucial for improving survival rates and treatment applicability.
Area of Science:
- Hepatology
- Oncology
- Public Health
Background:
- Hepatocellular carcinoma (HCC) is a highly malignant cancer and the third leading cause of death in Korea.
- It disproportionately affects men in their sixth to seventh decades, with high incidence and mortality rates.
- Hepatitis B virus (HBV) infection is a major risk factor, linked to high carrier rates in the Korean population.
Purpose of the Study:
- To emphasize the critical need for early detection of HCC due to limited survival improvements with current treatments.
- To evaluate the effectiveness of screening and surveillance programs in facilitating early HCC detection.
- To assess the potential of these programs in increasing the applicability of curative treatments for HCC.
Main Methods:
- Analysis of institutional data over the past 10 years.
- Comparison of clinical outcomes based on screening and surveillance program participation.
- Evaluation of HCC incidence, mortality, and risk factors (HBV, HCV) in the Korean population.
Main Results:
- Despite advances in HCC management, overall survival rates have shown minimal improvement over two decades.
- A significant proportion of HCC patients test positive for hepatitis B surface antigen (HBsAg) (65-75%) and hepatitis C virus (HCV) antibodies (10-20%).
- Screening and surveillance programs show promise in enabling earlier detection of HCC.
Conclusions:
- Early detection of HCC is paramount due to the limited efficacy of current treatments in improving long-term survival.
- Screening and surveillance programs are vital for identifying HCC at earlier, more treatable stages.
- These programs can potentially increase the number of patients eligible for curative therapies, thereby improving outcomes for HCC patients in Korea.
Abstract:
Hepatocellular carcinoma (HCC) is a highly malignant cancer and third major cause of death in Korean. It is more prevalent among men in the sixth to seventh decades. HCC is particularly prevalent in Korea where the age-standardized incidence rate is 45.0/100 000 population in males and 12.0/100 000 population in females. The death rate from HCC is 20.0/100 000 population. Approximately 65-75% of HCC patients were positive for hepatitis B surface antigen (HBsAg), where 10-20% of patients were anti-hepatitis C virus (HCV) positive. The high incidence rate of HCC in Korea is thought to be related to the high carrier rate of hepatitis B virus (HBV) in the general population. For primary prevention, a nationwide HBV vaccination program has been conducted since the late1980s in Korea. Although advances have been made in the various methods of management of HCC, there has been little overall survival improvement during the past 20 years. Only few patients are candidates for potentially curative forms of treatment. Therefore, the early detection of HCC is a key issue. When compared with clinical outcomes of HCC based on recent 10-year institutional data, our screening and surveillance programs might enable early detection and increased applicability of curative treatments.
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