DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20185097

Common causes and trends of hepatocellular carcinoma at regional cancer centre Raipur, India

Pradeep K. Chandrakar, Vivek Choudhary, Surendra K. Azad, Manjula Beck

Abstract


Background: Hepatocellular Carcinoma (HCC) is the most common primary malignancy of the liver and is the third most common cause of cancer related deaths in Asia-pacific region. Representative data on epidemiology of HCC in India is scanty and mostly from urban areas. It is more common in males then female. Hepatitis, alcohol consumption, aflatoxin and other hepatotoxins in diet are common causes. Authors did a study for the common causes and trends of the HCC registered at authors’ centre between January 2013 to November 2018.

Methods: Authors analyzed their hospital data for the patient registered with the diagnosis of hepatocellular carcinoma at their centre during the study period for age, sex, number and causes.

Results: Out of 23,766 patients registered for cancer in study period, 132 (0.55%) patients were of HCC, of which 89 (66.4%) were males and 43 (32.6%) were females, with ratio of 2:1. Commonest age group was between 50-59 years 46 (34.6%) followed by 40-49years 26 (19.5%). No patients were below 20 years of age. Among the commonest causes were alcohol consumption in 71 (53.4%), hepatitis B in 37 (27.8%), hepatitis C in 10 (7.5%), HIV in 4 (3%) and unknown in 11 (8.3%). There is rising trend in males and declining trend in females.

Conclusions: Incidence of hepatocellular carcinoma is low among all cancer but has high mortality rate. Alcohol consumption and hepatitis were the commonest cause. It is common above 40 years specially in males.


Keywords


Alcohol consumption, Causes, Hepatitis, Hepatocellular carcinoma, Trends

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References


GLOBOCAN. Population Fact Sheets: World; 2018. Available at: http://gco.iarc.fr/today/data/ factsheets/populations/900-world-fact-sheets.pdf.

Zhu RX, Seto WK, Lai CL, Yuen MF. Epidemiology of hepatocellular carcinoma in the Asia-Pacific region. Gut Liver. 2016 May;10(3):332.

Trevisani F, D'Intino PE, Caraceni P, Pizzo M, Stefanini GF, Mazziotti A, et al. Etiologic factors and clinical presentation of hepatocellular carcinoma. Differences between cirrhotic and noncirrhotic Italian patient. Cancer. 1995 May 1;75(9):2220-32.

Feitelson MA, Duan LX. Hepatitis B virus X antigen in the pathogenesis of chronic infections and the development of hepatocellular carcinoma. The Am J Pathol. 1997 Apr;150(4):1141-56.

Liu Z, Hou J. Hepatitis B virus (HBV) and hepatitis C virus (HCV) dual infection. Int J Med Sci. 2006;3(2):57-62.

El-Sherif A, Abou-Shady M, Abou-Zeid H, Elwassief A, Elbahrawy A, Ueda Y, et al. Antibody to hepatitis B core antigen as a screening test for occult hepatitis B virus infection in Egyptian chronic hepatitis C patients. J Gastroenterol. 2009 Apr 1;44(4):359-64.

Tsukuma H, Hiyama T, Tanaka S, Nakao M, Yabuuchi T, Kitamura T, et al. Risk factors for hepatocellular carcinoma among patients with chronic liver disease. New Eng J Med. 1993 Jun 24;328(25):1797-801.

Guptan RC, Thakur V, Sarin SK, Banerjee K, Khandekar P. Frequency and clinical profile of precore and surface hepatitis B mutants in Asian-Indian patients with chronic liver disease. Am J Gastroenterol. 1996 Jul 1;91(7).

Ferenci P, Fried M, Labrecque D, Bruix J, Sherman M, Omata M, et al. Hepatocellular carcinoma (HCC): a global perspective. J Clin Gastroenterol. 2010 Apr 1;44(4):239-45.

Association for the Study of the Liver E, Organisation for Research E, of Cancer T. EASL-EORTC Clinical Practice Guidelines: Management of Hepatocellular Carcinoma. 2012:56:908-43.

Dhir V, Mohandas KM. Epidemiology of digestive tract cancers in India. III. Liver. Indian J Gastroenterol. 1998;17(3):100-3.

GLOBOCAN 2018 fact sheet IARC. Cancer Incidence in Five Continents, IARC.; 2018. Available at: http://ci5.iarc.fr/CI5-XI/pdf/byhisto/C22.pdf.

NCDIR, NCRP I. Consolidated Report of HBCR 2012-14: leading sites of cancer. Banglore;2016. Available at: http://www.ncdirindia.org/NCRP/all_ncrp_reports/hbcr_report_2012_2014/all_content/pdf_Printed_Version/Chapter1.pdf.

NCDIR, NCRP I. Leading Sites of Cancers,Report from Population Based Registries from 2012-14. Bengaluru, India; 2016. Available at: http://www.ncdirindia.org/ncrp/all_ncrp _reports/pbcr_report_2012_2014/all_content/pdf_Printed_Version/Chapter2_Printed.pdf.

GLOBOCAN 2018 fact sheet. liver cancer. IARC. 2018. Available at: gco.iarc.fr/today/data/factsheets/cancers/11-Liver-fact-sheet.pdf.

NCDIR, NCRP I. Comparison of cancer incidence and patterns of all population based cancer registries.; 2016. Available at: http://www.ncdirindia.org/ncrp/all_ncrp_reports /pbcr_report_2012_2014/all_content/pdf_printed_version/chapter7.

Yang JD, Roberts LR. Hepatocellular carcinoma: a global view. Nature reviews Gastroenterol Hepatol. 2010 Aug;7(8):448-58.

Acharya SK. Epidemiology of Hepatocellular Carcinoma in India. J Clin Exp Hepatol. 2014 Aug; 4(Suppl 3): S27–S33.

Yeole BB. Trends in cancer incidence in esophagus, stomach, colon, rectum and liver in males in India. Asian Pac J Cancer Prev. 2008 Mar;9(1):97-100.

Bergsland EK, Venook AP. Hepatocellular carcinoma. Curr Opin Oncol. 2000;12(4):357-61.

Global Burden of Disease Liver Cancer Collaboration GB of DLC, Akinyemiju T, Abera S, et al. The burden of primary liver cancer and underlying etiologies from 1990 to 2015 at the global, regional, and national level: results from the global burden of disease study 2015. JAMA Oncol. 2017 Dec 1;3(12):1683-91.

Marrero JA, Fontana RJ, Fu S, Conjeevaram HS, Su GL, Lok AS. Alcohol, tobacco and obesity are synergistic risk factors for hepatocellular carcinoma. J Hepatol. 2005 Feb 1;42(2):218-24.