The changing epidemiology of hepatocellular carcinoma in Greece

Area of Science:

• Hepatology and Oncology
• Epidemiology of Cancer

Background:

• Hepatocellular carcinoma (HCC) is a globally prevalent malignancy, primarily linked to viral hepatitis, alcohol, and nonalcoholic fatty liver disease.
• Understanding the etiological shifts and diagnostic patterns of HCC is crucial for public health strategies.

Purpose of the Study:

• To analyze trends in risk factors and clinical presentation of HCC in Greece from 2000 to 2019.
• To compare current HCC patient characteristics with historical Greek cohorts.

Main Methods:

• Retrospective evaluation of 300 Greek HCC patients diagnosed between 2000 and 2019.
• Classification of patients into two periods: before 2011 (A) and after 2011 (B).
• Comparison of HCC risk factors and characteristics with historical Greek cohorts (1974-2000).

Main Results:

• A shift in HCC etiology was observed, with a decrease in hepatitis B virus (HBV) and an increase in hepatitis C virus (HCV) and non-viral liver diseases (nvLD).
• There was a trend towards a decrease in virally induced and an increase in non-virally induced HCC (P=0.075).
• Patients diagnosed after 2011 were more likely to have fewer and smaller HCC nodules, indicating earlier stage diagnosis.

Conclusions:

• In Greece, HCC etiology has shifted towards HCV and non-viral causes, with a recent trend favoring non-viral etiologies.
• Since 2011, HCC diagnosis has occurred at an earlier stage, potentially due to enhanced surveillance programs.
• These findings highlight evolving patterns in HCC development and diagnosis in Greece.