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Africa Guidelines for Hepatocellular Carcinoma Buildup Process
Ghassan K Abou-Alfa1,2,3, Mary Afihene4, Marinela Capanu1,2
1Memorial Sloan Kettering Cancer Center, New York, NY.
JCO Global Oncology
|November 9, 2023
Summary
Hepatocellular carcinoma (HCC) care in Africa faces significant access and availability gaps, particularly in Central and East/West Africa. Concerted efforts are needed to reduce HCC incidence and mortality across the continent.
Area of Science:
- Hepatology
- Oncology
- Public Health
Background:
- Hepatocellular carcinoma (HCC) is a major health challenge in Africa, with a survival rate of only 3 months.
- Low GDP, limited HDI, and lack of guidelines contribute to poor outcomes.
Purpose of the Study:
- To assess real-world access to screening, diagnosis, and treatment for HCC in different African regions.
- To identify disparities in HCC care across North/Southern Africa (NS), East/West Africa (EW), and Central Africa (C).
Main Methods:
- An open forum with HCC experts was conducted in October 2021.
- Participants (372 from Africa) completed a survey on HCC management practices and resource availability.
Main Results:
- Hepatitis B vaccination and treatment are common; however, advanced diagnostics like image-guided biopsy are underutilized (20%).
- Liver transplant availability is very low (28% NS, 3% EW), and resection is limited in Central Africa.
- Access to systemic therapies like sorafenib is widespread (66%), but second-line treatments and newer agents (e.g., immune checkpoint inhibitors) are scarce.
Conclusions:
- Significant disparities exist in HCC care across Africa, with Central and East/West Africa facing the most substantial gaps.
- Multidisciplinary collaboration is essential to improve HCC management and reduce mortality continent-wide.
