Africa guidelines for hepatocellular carcinoma buildup process Journal Article
| Authors: | Abou-Alfa, G. K.; Afihene, M.; Capanu, M.; Li, Y.; Chou, J. F.; Asombang, A.; Alatise, O. I.; Bounedjar, A.; Cunha, L.; Mekonnen, H. D.; Diop, P. S.; Elwakil, R.; Ali, M. M.; Ndlovu, N.; Ndumbalo, J.; Makondi, P. T.; Tzeuton, C.; Biachi de Castria, T.; Agyei-Nkansah, A. A.; Balogun, F.; Bougouma, A.; Atipo Ibara, B. I.; Jonas, E.; Kimani, S.; Kingham, P.; Kurrimbukus, R.; Hammad, N.; Fouad, M.; El Baghdady, N.; Servais Albert Fiacre, E. B.; Sewram, V.; Spearman, C. W.; Yang, J. D.; Roberts, L. R.; Abdelaziz, A. O. |
| Article Title: | Africa guidelines for hepatocellular carcinoma buildup process |
| Abstract: | PURPOSE: Hepatocellular carcinoma (HCC), the fourth most common cancer in Africa, has a dismal overall survival of only 3 months like in sub-Saharan Africa. This is affected by the low gross domestic product and human development index, absence of coherent guidelines, and other factors. METHODS: An open forum for HCC-experienced health care workers from Africa and the rest of the world was held in October 2021. Participants completed a survey to help assess the real-life access to screening, diagnoses, and treatment in the North and Southern Africa (NS), East and West Africa (EW), Central Africa (C), and the rest of the world. RESULTS: Of 461 participants from all relevant subspecialties, 372 were from Africa. Most African participants provided hepatitis B vaccination and treatment for hepatitis B and C. More than half of the participants use serum alpha-fetoprotein and ultrasound for surveillance. Only 20% reported using image-guided diagnostic liver biopsy. The Barcelona Clinic Liver Cancer is the most used staging system (52%). Liver transplant is available for only 28% of NS and 3% EW. C reported a significantly lower availability of resection. Availability of local therapy ranged from 94% in NS to 62% in C. Sorafenib is the most commonly used systemic therapy (66%). Only 12.9% reported access to other medications including immune checkpoint inhibitors. Besides 42% access to regorafenib in NS, second-line treatments were not provided. CONCLUSION: Similarities and differences in the care for patients with HCC in Africa are reported. This reconfirms the major gaps in access and availability especially in C and marginally less so in EW. This is a call for concerted multidisciplinary efforts to achieve and sustain a reduction in incidence and mortality from HCC in Africa. |
| Keywords: | sorafenib; hepatitis b; liver cell carcinoma; carcinoma, hepatocellular; liver neoplasms; liver tumor; epidemiology; africa; humans; human |
| Journal Title: | JCO Global Oncology |
| Volume: | 9 |
| ISSN: | 2687-8941 |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2023-01-01 |
| Start Page: | e2300159 |
| Language: | English |
| DOI: | 10.1200/go.23.00159 |
| PUBMED: | 37944087 |
| PROVIDER: | scopus |
| PMCID: | PMC10645406 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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