Hepatocellular Carcinoma In Asia, Prevention Strategy And Planning

Ashtari SARA, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Iran
MOHAMAD AMIN P. 1 , ZALI M. 1 , FAZELI Z. 1

1 Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Purpose: To review all of epidemiological and etiological aspects of Hepatocellular carcinoma and examined the prevention of this disease in Asia.
METHODS: We conducted a systematic review according to the PRISMA guidelines. We were chosen articles that published previously, from PubMed (Medline), the Cochrane database and Scopus. The key words used in this research were as follows: Hepatocellular carcinoma in Asia and the way of prevention of this disease, with no language limitations.  
RESULTS: More than 70% of all new cases of liver cancer were diagnosed in Asia, a region that 75% of all those chronically infected with hepatitis B virus in the world. Chronic hepatitis B virus (HBV) infection is the main cause of Hepatocellular carcinoma (HCC) in Asia. The prevalence of this cancer is high in Eastern and South-Eastern Asia, But Middle Eastern countries are characterized as moderate prevalence rate of HCC region and Central Asia and some part of Middle Eastern countries are known as low prevalence rate of HCC. In addition of HBV and HCV the other factors such as aflatoxin, alcohol, obesity, diabetes and non-alcohol fatty liver disease (NAFLD) might be responsible for a low prevalence of HCC in Asian countries. Currently available HCC therapies, chemotherapy, surgical are inefficient, mainly due to usually late diagnosis and high recurrence rates after surgical resection, and usually end with treatment failure. Liver transplantation also remains as a difficult strategy in patients with HCC. Thus prevention of HCC by treating and prevention HBV and HCV infection, the major causative agents of HCC.
CONCLUSION: The main challenge which still present in Asia, is the high prevalence of chronic hepatitis. So, prevention of HBV and HCV is the key strategy to reduce the incidence of HCC in Asia.