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CC BY-NC-ND 4.0 · South Asian J Cancer 2024; 13(01): 010-016
DOI: 10.1055/s-0043-1771440
Original Article
International

Changes in the Etiologies of Liver Cancer in Upper Egypt over a Decade from 2010 to 2020: A Single Tertiary Care Center Study

Yasser Fouad
1   Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Cairo, Egypt
,
Yasmine Gaber
2   Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt
,
Shereen Abdel Alem
2   Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt
,
Mohamed Abdallah
3   Department of Medical Research Division Medicine, National Research Centre, Giza, Egypt
,
Sherief M. Abd-Elsalam
4   Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
,
Shaymaa Nafady
5   Department of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
,
Dina Attia 
5   Department of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
,
Mohamed Eslam
6   Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, New South Wales, Australia
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Abstract

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Yasser Fouad

The profile of liver diseases in Egypt is changing dramatically and viral hepatitis is declining, while the fatty liver disease is increasing dramatically. However, the impact of these changes on the profile of hepatocellular carcinoma (HCC) remains uncertain. Therefore, we determined the temporal trends in the etiologies of HCC in Egypt over a decade. We retrospectively analyzed data from consecutive patients who were diagnosed with HCC over 10 years (2010–2020) in a large center in Upper Egypt. Standard tests were utilized to diagnose hepatitis C virus (HCV) and hepatitis B virus. In the absence of other liver disorders, the presence of obesity, or diabetes in the absence of other risk factors, metabolic dysfunction-associated fatty liver disease (MAFLD) was diagnosed. A total of 1,368 HCC patients were included, in which 985 (72%) had HCV, 58 (4%) had hepatitis B virus, and 143 (10.5%) had MAFLD, 1 patient had hemochromatosis, 1 had autoimmune liver disease, and 180 (13%) patients were with unknown cause. The annual proportions of MAFLD-related HCC were increased significantly between 8.3% in 2010 and 20.6% in 2020 (p = 0.001), while HCV-related HCC declined from 84.8 to 66.7% (p = 0.001). Throughout the study period, there were significant increases in the age at diagnosis of HCC, the proportion of female patients, obesity, diabetes, and less severe liver dysfunction at diagnosis (p < 0.05 for all). With the decline of HCV, MAFLD is becoming a major cause of HCC in Egypt, which has increased substantially over the past 10 years. This study urges the creation of comprehensive action strategies to address this growing burden.

Keywords

HCC - Egypt - MAFLD - viral hepatitis - trends

Patients' Consent

A general authorization was included to collect nominative data and analyze anonymized data with a waiver of informed consent due to the low risk to participants and the disproportionate difficulty in obtaining informed consent due to HCC's high mortality.


Note

No animals were used in this research. All human research procedures followed were in accordance with the ethical standards of the committee responsible for human experimentation (institutional and national), and with the Helsinki Declaration of 1975, as revised in 2013.


Ethical Approval

The ethics committee in Minia University, Egypt, approved this study.


Data Availability Statement

The authors' institution does not allow public data access.




Publication History

Article published online:
03 August 2023

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