In a study on liver cancer by Yang, Ju Dong et al; they reported that in Nigeria, hepatitis B is the most common cause of liver cancer.
The incidence of hepatocellular (liver) carcinoma of (8·9 cases per 100 000 person-years) is higher in Africa than in most of the rest of the world because of high prevalences of chronic infections with hepatitis B and C.
They said that hepatocellular (liver) carcinoma is a leading cause of cancer-related death in many African countries because of the combination of high incidence and high cancer-specific mortality.
Furthermore, they reported that liver cancer is seen at a younger age in Africa at an average age of 45 years. That in addition to its high incidence, hepatocellular carcinoma is diagnosed at an earlier age and at more advanced stages in Africa than in the rest of the world.
The report also noted that the dismal prognosis of patients with hepatocellular carcinoma in other African countries is consistent with anecdotal reports but still striking, with a median survival of patients with hepatocellular carcinoma of only 10 weeks.
This means that the average patient in Africa who is diagnosed with liver cancer does not survive beyond 10 weeks after diagnosis.
The recommendation of the group is as follows
- Primary prevention of chronic hepatitis
- Universal HBV vaccination,
- Identification of the at-risk population (patients with HCV or HBV) by mass screening of the general population,
- Prevention of liver disease progression and hepatic dysfunction by providing antiviral treatment
- Minimisation of aflatoxin exposure through post-harvest interventions
- Implementation of hepatocellular carcinoma surveillance among the population at risk for the disease
- Establishment of centers of excellence for hepatocellular carcinoma treatment for essential components of attempts (both ongoing and future) to curb the morbidity and mortality from hepatocellular carcinoma in Africa.
Take home point:
Please get vaccinated against hepatitis B.
Vaccination will protect against infection with hepatitis B virus and prevent the development of liver cancer.
Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium
Yang, Ju Dong et al.
The Lancet Gastroenterology & Hepatology , Volume 2 , Issue 2 , 103 – 111
Article compiled by Dr. Ngozi Onuoha, MD, MBA-HCM