Tackling Hepatocellular Carcinoma (HCC): Navigating from Epidemiology to Precision Medicine

Introduction:

Hepatocellular carcinoma (HCC), a primary liver cancer, presents a growing global health challenge. Mortality rates, especially in the Western world, are on the rise, demanding a reassessment of prevention, surveillance, and treatment. A significant epidemiological shift has occurred, with non-viral liver diseases surpassing virus-related causes as the primary contributor to HCC.

Prevention Triumphs Against Virus-Related HCC:

In primary prevention, strides against virus-related HCC are notable. Hepatitis B vaccination has significantly decreased HCC incidence, and antiviral therapy has prevented cirrhosis and HCC development.

Challenges in Non-Viral Liver Diseases:

However, non-viral liver diseases present formidable challenges. Chemoprevention remains elusive, with associations between certain medications and reduced HCC risk requiring further research.

Secondary Prevention and Surveillance:

In secondary prevention, semi-annual ultrasonography-based surveillance of cirrhosis patients is vital for early detection and improved survival. Despite proven benefits, surveillance underutilization, especially among patients with non-viral liver disease, highlights the need for comprehensive interventions.

Therapeutic Breakthroughs: A Beacon of Hope:

Transformative breakthroughs in HCC therapy offer hope. Established treatments, including surgical resection, liver transplantation, and locoregional therapies, are expanding the scope of curative options.

Immune-Checkpoint Inhibitors Revolutionizing HCC Therapy:

Immune checkpoint inhibitors are revolutionizing HCC therapy, showing remarkable efficacy in advanced and earlier-stage diseases by harnessing the patient's immune system.

Conclusion: A Glimmer of Hope Amidst the Challenge:

Global HCC epidemiology is dynamic, with non-viral liver diseases playing a prominent role. While primary prevention against virus-related HCC is successful, chemoprevention for non-viral liver diseases remains elusive. Optimizing surveillance practices is crucial. Advances in HCC therapy offer hope, but a collaborative approach is essential to effectively combat this global health challenge.

References:

1. https://www.nature.com/articles/s41571-023-00825-3

1. https://pubmed.ncbi.nlm.nih.gov/30455585/
2. https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.32723
3. https://www.nature.com/articles/s41571-023-00825-3#:~:text=Accordingly%2C%20the%20epidemiology%20of%20HCC,agents%20(DAAs)%20to%20treat%20HCV