Hepatocellular carcinoma in an urbanised black community. A changing pattern

Hepatocellular carcinoma has been extensively studied in Southern Africa, and particularly its relationship to hepatitis B virus infection. Most of this work involved rural Black populations. In this study the impact of urbanization on this relationship is investigated. The material is derived from the laboratory records at Baragwanath Hospital which serves the Black urban community of Soweto, Cases autopsied during the periods 1956-1960 and 1976-1980 have been examined with regard to age, sex, underlying cirrhosis and presence of HBsAg in the non-tumour liver. In addition, all biopsies from 1955 to 1980 have been analysed with respect to age and sex. There is evidence of a significant increase in overall average age and in the proportion of female cases, while the percentage of HBsAg positive cases has fallen. Possible causes for these findings are considered.