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World J Hepatol. Nov 27, 2014; 6(11): 783-792
Published online Nov 27, 2014. doi: 10.4254/wjh.v6.i11.783
Published online Nov 27, 2014. doi: 10.4254/wjh.v6.i11.783
Problem of hepatocellular carcinoma in West Africa
Nimzing G Ladep, Maud Lemoine, Mary ME Crossey, Simon D Taylor-Robinson, Hepatology Unit, Imperial College London, St Mary’s Hospital Campus, London W2 1NY, United Kingdom
Olufunmilayo A Lesi, Department of Medicine, College of Medicine, University of Lagos, Plateau State 930001, Nigeria
Pantong Mark, Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State 930001, Nigeria
Charles Onyekwere, Department of Medicine, Lagos State University College of Medicine/Teaching Hospital, Lagos 100001, Nigeria
Mary Afihene, Department of Medicine, Komfo Anokye Teaching Hospital, PO Box 1934, Kumasi, Ghana
Author contributions: Ladep NG conceptualised, organised, wrote, corresponding author of article and approved final version; Lesi OA wrote sections of challenge of surveillance and treatment of HCC, corrected several other sections and approved final version; Mark P wrote sections of clinical presentations of HCC in West Africa, provided pictures for Figures 3 and 4 and approved final version; Lemoine M wrote the sections of challenges of diagnosis, treatment of HCC in West Africa and approved final version; Onyekwere C wrote section of reasons for poor survival of HCC in West Africa and approved final version; Afihene M co-wrote challenge of surveillance, treatment of HCC and approved final version; Crossey MME made several amendments, suggestions to improve article and approved final version; Taylor-Robinson SD is the guarantor of the article, co-wrote conclusions and recommendations with Ladep NG and approved final version.
Supported by Fellowships from The London Clinic, London, United Kingdom (to Dr. Ladep); from the Halley Stewart Foundation, Cambridge, United Kingdom (to Mary ME Crossey)
Correspondence to: Nimzing G Ladep, MBBS, PhD, FWACP, Hepatology Unit, Imperial College London, 10th Floor, QEQM Building, St Mary’s Hospital Campus, South Wharf Road, London W2 1NY, United Kingdom. n.ladep@imperial.ac.uk
Telephone: +44-20-33121909 Fax: +44-20-33123395
Received: July 4, 2014
Revised: August 8, 2014
Accepted: September 16, 2014
Published online: November 27, 2014
Revised: August 8, 2014
Accepted: September 16, 2014
Published online: November 27, 2014
Core Tip
Core tip: It is known that outside the region of East Asia, sub-Saharan Africa has the highest incidence of hepatocellular carcinoma (HCC). Within Africa the West African region remains the focus of significant disease activity. We reviewed the main issues responsible for this pattern. Although intervention efforts, such as primary prevention through hepatitis B vaccination, has led to reductions of chronic hepatitis B infection in some countries such as Gambia and Senegal, there remains a huge gap in secondary prevention, which are responsible for continuing high mortality to incidence ratio of HCC in West Africa. Collaborative clinical care and basic science translational research holds promise towards changing the current trend.