HCC in the Arab World Final
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Transcript of HCC in the Arab World Final
Liver Cancer in Arab World
By Heba El Zawahry M.D.
Prof. and Head of Medical Oncology Department National Cancer institute
Cairo University
HCC incidencetripled over the last three decades
Altekruse, JCO 2009
in 2012 worldwide, there were 14.1 million new cancer cases, 8.2 million cancer deaths and 32.6 million people living with cancer (within 5 years of diagnosis)the real problem is that 57% (8 million) of new cancer cases, 65% (5.3 million) of the cancer deaths and 48% (15.6 million) of the 5-year prevalent cancer cases occurred in the less developed regions.
WHO 2012 report
Liver Cancer World (Age-Standardised) Incidence Rates, World Regions, 2008 Estimates
Liver Cancer , Average Number of New Cases per Year and Age-Specific Incidence Rates, world wide 2008-2010
Liver cancer world wide age adjusted incidence
per 100,000
GLOBCAN 2012
Incidence according to etiology
Abbreviations: WD, Wilson s disease; PBC, primary biliary cirrhosis, HH, hereditary hemochromatosis; HBV, hepatitis ′B virus infection; HCV, hepatitis C virus infection.
Prevalence of HCV globally
Global Burden of Hepatitis C: Considerations for Healthcare Providers
Globally, an estimated 130–170 million persons (2%–3% of the world's population) are living with (HCV) infection . More than 350 000 deaths are attributed to HCV infection each year, most of which are caused by liver cirrhosis and HCC. An estimated 27% of cirrhosis and 25% of HCC can be attributed to hepatitis C worldwide, and disease rates can be even more substantial in countries with a high burden of infection. For example, in Japan, up to 90% of all reported cases of HCC are caused by HCV infection
Scientific World Journal. 2012; 2012: 719494. Hepatitis C Virus in Arab World: A State of Concern
Distribution of hepatitis C virus genotypes in Middle East
Incidence of liver cancer
HCC in Arab world
Reports from some Arabic countries:EgyptLebanon Saudi Arabia
HCC in Egypt
• Population based registry• Cancer registry Nationwide • Hospital based registry
Number of cases
Amal samY Ibrahim NCI
ASIR: Age Standardized incidence rate
Presented by:Ali Shamseddine, MD.
Professor, Head Hematology Oncology AUB
VP /NCR
NATIONAL CANCER REGISTRYCANCER IN LEBANON
2003 & 2004
PRIMARY SITES N
AGE-SPECIFIC RATES per 100,000 CRUDE
RATES
ASR
UN 0-14 15-24 25-34 35-44 45-54 55-64 65-74 75+
Oro-pharynx 72 12 0.18 0.55 0.70 1.49 9.62 17.47 11.33 17.00 4.03 3.79
Stomach 114 12 0.18 0.55 0.70 4.48 8.25 19.06 36.26 56.65 6.39 6.17
Colon-rectum 281 26 0.55 0.28 4.55 9.96 23.37 43.69 87.25147.3
0 15.74 15.43
Liver 33 3 0.18 0.28 0.35 0.50 2.06 3.1817.0
011.3
3 1.85 1.77Pancreas 58 4 0.00 0.00 0.00 1.49 8.25 9.53 23.80 17.00 3.25 3.38
Larynx 103 11 0.00 0.00 0.35 2.49 9.62 15.89 35.13 59.49 5.77 5.62
Lung 546 51 0.92 0.28 1.40 13.45 55.67112.0
0175.6
3280.4
4 31.6 31.62Skin melanoma 55 5 0.18 1.10 0.00 3.49 6.19 5.56 12.46 31.16 3.08 3.04
Prostate 587 79 0.00 0.00 0.35 0.50 14.43 81.02264.0
1424.9
1 32.89 29.88
Testis 79 2 1.48 3.31 8.75 9.96 5.50 2.8 0.00 2.83 4.43 4.29
Kidney 67 5 0.74 0.28 0.70 2.49 6.87 13.50 19.26 17.00 3.75 3.81
Bladder 569 80 0,18 0.00 2.80 11.46 32.99101.6
7193.7
6311.6
0 31.88 29.51
CANCER INCIDENCE RATES AMONG MALES IN LEBANON 2003
HCC in Saudi Arabia
Incidence of HCC in Saudi Arabia among new cancer cases 16,437
GLOBOCAN 2002
Causes of death among all cancer cases in Saudi Arabi 10,911
GLOBOCAN 2002
Hepatocellular carcinoma in Saudi Arabia: Role of hepatitis B infection.
N=118 N=118
Ayoola EA J Gastroenterol Hepatol. 2004; 19(6):665-9
1.9 per 1000
(2.3 in men, 1.2 in women).
Conclusion - HCC is increasing world wide and showed definite
increase in countries where HCV and HBV are prevalent.
- Egypt represents an example of definite association between chronic HCV and high incidence and HCC.
- Mortality from HCC is accounting for number one cause of death among all male cancers and may be the 4th cause of death in female cancers.
- The real challenge for HCC is that the presence of cirrhosis and patients late presentation threaten the value of any curative treatment.
Call for Co-operative group
Pan Arab hepatocellular carcinoma group
??
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