Prevention of hepatocellular carcinoma in the Asia-Pacific region: Consensus statements

Among approximately 650 000 people who die from hepatocellular carcinoma (HCC) each year, at least two‐thirds live in Asia. Efforts to improve early diagnosis and treatment have not yet impacted mortality. An Asia–Pacific Working Party convened in Hong Kong in June 2008 to consider ways to prevent H...

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Bibliographic Details
Published in:Journal of gastroenterology and hepatology 2010-04, Vol.25 (4), p.657-663
Main Authors: Asia-Pacific Working Party on Prevention of Hepatocellular Carcinoma, Asia–Pacific Working Party on Prevention of Hepatocellular Carcinoma
Format: Article
Language:English
Subjects:
Antiviral Agents - therapeutic use
Asia
Australia
Biological and medical sciences
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - etiology
Carcinoma, Hepatocellular - prevention & control
Comorbidity
Disease Progression
Early Detection of Cancer
Evidence-Based Medicine
Gastroenterology. Liver. Pancreas. Abdomen
Hemochromatosis - complications
Hemochromatosis - diagnosis
Hemochromatosis - therapy
hepatitis B vaccination
Hepatitis B Vaccines
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - diagnosis
Hepatitis B, Chronic - prevention & control
Hepatitis B, Chronic - transmission
hepatitis C virus
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - diagnosis
Hepatitis C, Chronic - prevention & control
Hepatitis C, Chronic - transmission
Human viral diseases
Humans
Infection Control
Infectious diseases
Liver Neoplasms - diagnosis
Liver Neoplasms - etiology
Liver Neoplasms - prevention & control
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Mass Screening - methods
Medical sciences
Primary Prevention
Risk Assessment
Risk Factors
Secondary Prevention
surveillance for HCC
Tumors
universal precaution
Viral diseases
Viral hepatitis
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Summary:Among approximately 650 000 people who die from hepatocellular carcinoma (HCC) each year, at least two‐thirds live in Asia. Efforts to improve early diagnosis and treatment have not yet impacted mortality. An Asia–Pacific Working Party convened in Hong Kong in June 2008 to consider ways to prevent HCC in this region. Separate reviews have summarized epidemiology of HCC, preventive approaches related to hepatitis B virus (HBV), hepatitis C virus (HCV) and non‐viral liver diseases, and the role of surveillance to detect HCC at a curative stage. We now present Consensus Statements from these deliberations and reviews. As chronic hepatitis B is the most common cause of HCC in Asia, effective hepatitis B vaccination programs are the most important strategy to reduce HCC incidence. Prevention of HCV by screening blood donors, universal precautions against blood contamination in health‐care settings and reducing HCV transmission from injection drug use are also vital. There is strong evidence that effective antiviral therapy to control HBV infection or eradicate HCV substantially reduces (but does not abolish) HCC risk. With hemochromatosis, family screening, early diagnosis and correcting iron overload to prevent liver fibrosis prevents HCC. There is currently insufficient evidence to give firm recommendations on alcohol, obesity/metabolic risk factors and other liver diseases. HCC surveillance for high‐risk groups is recommended in individual cases but cost‐effectiveness is not as high as infant hepatitis B vaccination and screening blood for HCV. Widespread application of HCC surveillance in Asia–Pacific countries depends on economic factors and health‐care priorities.
ISSN:0815-9319
1440-1746
DOI:10.1111/j.1440-1746.2009.06167.x