Age cohort screening for hepatocellular carcinoma in an African population

Abstract

Background: Hepatocellular carcinoma (HCC) is a disease of global and public health significance. In Africa, HCC is the fourth most common cancer and sub-Saharan Africa is a hotbed for HCC due to high prevalence of hepatitis B (HBV) and hepatitis C (HCV) virus infections. The late presentation in African patients has been well documented with attendant bad prognosis. We undertook this study to determine if there is an age-related clustering of HCC based on etiology. Methods: This was a retrospective hospital-based study from records of 425 adult patients (18 years and above) with triphasic computed tomography confirmed HCC at the Jos university teaching hospital, Jos, Nigeria. Relevant data were extracted from the database into an Excel spreadsheet with subsequent analysis based on age and risk factors of HCC. Results: Of 425 patients included in this study, 323 (76%) were male. The overall mean (± standard deviation) age for the studied population was 48.8 ± 14.6 years: 48.8 + 14.5 years for females and 48.9 + 14.6 years for males. 44.7% had HBV and 28% had HCV. There was a significant difference in the mean age of those with HBV as against HCV (43.0 ± 12.5 years vs. 54.3 ± 14.2 years; P < 0.001). Among those who had HCV as a risk factor for HCC, the majority (31.9%) were in the age group of 51–60 years while most of those with HBV (32.1%) were in the 31–40 years of age group. Conclusion: In this African cohort, HBV-related HCC presented a decade earlier than HCV-related HCC. Targeted screening strategies for HCC may take this into account.