Liver Cancer in Nepal.

Area of Science:

• Hepatology
• Oncology
• Public Health

Background:

• Hepatocellular carcinoma (HCC) is a significant health concern in South Asia.
• Nepal exhibits a lower incidence of HCC, attributed to a lower prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.
• The establishment of a comprehensive national cancer registry in Nepal is recent, with current data from twelve centers potentially not reflecting the full cancer burden.

Purpose of the Study:

• To review the clinical characteristics of Hepatocellular Carcinoma (HCC) in Nepal.
• To assess the prevalence of HBV and HCV in Nepalese HCC patients.
• To evaluate the accessibility and affordability of HCC treatment modalities in Nepal.

Main Methods:

• Mini-review of existing literature and clinical data on HCC in Nepal.
• Analysis of serological data for HBV and HCV in HCC cases.
• Assessment of the availability and cost of standard HCC treatments in the country.

Main Results:

• Serological evidence of HBV and HCV infections is present in approximately 25-30% and 5-10% of HCC cases, respectively.
• Patients in Nepal frequently present with poor performance status and advanced-stage HCC.
• A limited proportion of patients are eligible for curative treatment due to late-stage diagnosis.
• Standard HCC treatments are available and relatively affordable in Nepal compared to developed countries.

Conclusions:

• Despite a lower overall incidence, HCC in Nepal is often diagnosed at an advanced stage, complicating treatment.
• The availability and affordability of standard treatments offer some hope, but early detection remains a challenge.
• Further efforts in establishing robust cancer registries and improving early diagnostic strategies are crucial for better HCC management in Nepal.