Prevalence and epidemiological features of hepatocellular carcinoma in Egypt - a single center experience

Background: The studies carried out on hepatocellular carcinoma (HCC) are s carce in Egypt. Nevertheless, they presumed an upward trend for HCC among c hronic liver disease (CLD) patients. The objectives of this research were t o determine the trend of HCC, the possible risk factors implicated in its d evelopment and the population attributable risk of HCVAb and HBsAg positivi ty for HCC. Methods: Medical records of all patients attending Cairo Liver Center juring the years 1992-1445 were reviewed to determine the sociodemog raphic characteristics, HCVAb, HBsAg and HCC status. Prospectively, 200 HCC cases' stored sera as well as 120 healthy control were tested for aflatoxi n B-1 quantitatively and qualitatively. Results: HCC accounted for 4.7% (32 1/6850) of CLD patients included in the study. HCVAb positive cases were st rikingly high (71.1%) and HBsAg positive cases were reported in 22.4% of pa tients. There was an annual significant rise of HCC ranging from 3.6% in 19 92 to 5.3% in 1995. HCC was significantly more prevalent among old age grou ps (60 years) than younger age groups. The impact of gender and past histor y of schistosomiasis on HCC was not proved by this study. I HCVAb and HBsAg positivity were the two significant independent risk factors for HCC. The population attributable risk percent has shown that IICC cases attributed t o HCVAb positivity accounted for 51.1%; while HBsAg positivity only explain ed 21.3% of cases. Aflatoxin B-1 was detected in 17% of HCC cases compared to 9.4% of healthy control. Risk ratio = 2(95%). Conclusion: HCC is showing an increasing trend among our patients. Its development is mainly due to h igh rates of HCVAb and HBsAg positivity. HBsAg positive patients were at do uble risk to develop HCC and HCVAb positive patients were at. 1.6 more risk . The high prevalence of HCVAb positivity renders its contribution to the d evelopment of HCC over seven-fold higher than HBsAg positivity. Short and l ong term health strategies are crucial to prevent and control HCC in Egypt. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.