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Hepatocellular carcinoma: Epidemiology, pathogenesis and surveillance – implications for sub-Saharan Africa

K Zakharia, C A Luther, H Alsabbak, L R Roberts

Abstract


Hepatocellular carcinoma (HCC) originates from hepatocytes usually secondary to chronic inflammation and cirrhosis. It is an important disease of global significance with a high incidence and mortality. It is the fifth and eighth most common cancer in males and females, respectively. HCC is also extremely lethal; in 2015 it was the second and sixth most common cause of death from cancer in males and females, respectively. Chronic viral hepatitis B and C are the most frequent risk factors for the development of HCC, and the global distribution of HCC largely mirrors that of chronic viral hepatitis. More recently, there has been a notable increase in the incidence of HCC as a result of obesity-related fatty liver disease. Here, we review the epidemiology of HCC, examine recent advances in our understanding of the pathogenesis of HCC, discuss the implications for identification of potential therapeutic targets, and provide the most updated recommendations on surveillance for HCC, with particular attention to the unique challenges and potential opportunities to reduce the burden of illness and death from HCC in sub-Saharan Africa.


Authors' affiliations

K Zakharia, Internal Medicine Residency Program, Department of Medical Education, Beaumont Health, Dearborn, Michigan, USA; Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA

C A Luther, Department of Dermatology, Henry Ford Health System, Detroit, Michigan, USA

H Alsabbak, Internal Medicine Residency Program, Department of Medical Education, Beaumont Health, Dearborn, Michigan, USA

L R Roberts, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA

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Cite this article

South African Medical Journal 2018;108(8b):35-40. DOI:10.7196/SAMJ.2018.v108i8b.13499

Article History

Date submitted: 2018-08-08
Date published: 2018-08-08

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