O-9 THE CHANGING EPIDEMIOLOGY OF HEPATOCELLULAR CARCINOMA IN SOUTH AMERICA: A REPORT FROM THE SOUTH AMERICAN LIVER RESEARCH NETWORK

Abstract

Introduction and Objectives: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide and most epidemiological data originates from resource-rich countries. We have previously described the epidemiology of HCC in South America through the South American Liver Research Network (SALRN). Here, we provide an update on the changing epidemiology of HCC in the continent over the last two years. Materials and Methods: We evaluated HCC cases diagnosed between 2019 to 2021 in six centers from six countries in South America. A retrospective chart review of patient characteristics at the time of HCC diagnosis, including demographic, clinical and laboratory data, was completed. Diagnosis of HCC was made radiologically or histologically for all cases via institutional standards. Each center provided ethical approval for the study. Results: A total of 339 HCC cases were included [Peru 37% (n = 125), Brazil 16% (n = 57), Chile 15% (n =51), Colombia, 14% (n = 48), Ecuador 9% (n = 29) and Argentina, 9% (n = 29)]. 61% of patients were male and the median age of diagnosis was 67 years (IQR 59-73). The most common risk factor for HCC was nonalcoholic fatty liver disease NAFLD (37%), followed by Hepatitis C infection (17%), alcohol use disorder (11%) and Hepatitis B infection (12%). The proportion of NAFLD-related HCC was much higher than in our previous report (37% compared to 11%). The majority of HCCs occurred in the setting of cirrhosis (80%), and the most common cause of non-cirrhotic HCC was HBV (31%) and NAFLD (28%). HBV-related HCC occurred at a younger age compared to other causes, with a median age of 46 years (IQR 36-64). Conclusions: We report changes in the epidemiology of HCC in South America over the last 10 years, with a substantial increase in NAFLD-related HCC. HBV-related HCC still occurs at a much younger age when compared to other causes.