Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.116
Peer-review started: November 7, 2017
First decision: December 4, 2017
Revised: December 15, 2017
Accepted: January 15, 2018
Article in press: January 15, 2018
Published online: January 27, 2018
Hepatocellular carcinoma (HCC) is currently the world’s second deadliest cancer. HCC is closely linked to viral hepatitis, which in turns has been reported to have high epidemiologic heterogeneity especially in the developing world. There is limited epidemiological data on HCC reported in Vietnam, particularly the southern and central regions.
This study primarily seeks to elucidate the epidemiological characteristics of HCC in southern and central Vietnam. These results have significant policy and research implications in establishing priorities for public health interventions, financial allocations, and driving knowledge acquisition in further large-scale observational studies and potential biomarker testing expansion.
The authors sought to evaluate the burden of HCC and characteristics of patients presenting with HCC, as well as potential disease etiology.
The authors conducted an epidemiological observational study from 2000 to 2016, using a large database of patients with liver cancer who receive care at Cho Ray Hospital, the largest tertiary referral center in southern and central Vietnam. Information on patient demographic information, disease staging, and tumor marker results were extracted.
Analysis was performed on 24091 patients from 2010 to 2016, with increasing disease frequency noted (2793 patients in 2010 to 4069 in 2016). Most patients were male (86.4%), most patients presented with advanced disease (40.8%). Most patients were found to have viral hepatitis (89.6%), with 62.3% with HBV, 26.0% with HCV, and 2.7% with HBV-HCV coinfection. Eight point five percent of patients were younger than 40 years old.
In the largest epidemiological study conducted for liver cancer in Vietnam to date, we find high and increasing disease burden from 2010 to 2016, which manifests as advanced disease and co-prevalent with viral hepatitis. Demographic patterns suggest higher disease burden on males and disproportionate burden on younger patients.
These findings emphasize the importance of developing systems and methods to better understand epidemiology of liver cancer, as well as for linkage to care, evaluation, and treatment of both liver cancer and viral hepatitis. Future research should focus on health care services and policy implications for disease screening and treatment outcomes for this population.