IDDF2023-ABS-0224 Evaluating the changing trends in hepatocellular carcinoma cases in a multi-cultural australian tertiary hospital

BackgroundHepatocellular carcinoma (HCC) is increasing globally. Whilst viral hepatitis remains an important risk factor, the prevalence of the non-alcoholic fatty liver disease is rising and may become the leading cause of HCC. We evaluate the changing trends of HCC cases in our tertiary hospital with a multi-cultural population.MethodsWe examined patients referred to HCC multi-disciplinary meeting at Liverpool Hospital in Sydney, Australia. Prospectively collected data were reviewed from the database.ResultsBetween January 2014 – December 2021, 530 new liver tumour cases were reviewed with 392 (74%) diagnosed as HCC. The mean age at diagnosis was 64 (range 21-89), with 312 (80%) of patients being male. Patients were identified as Caucasian (44.6%), Asian (31.9%), Middle-Eastern (6.4%), Polynesian (6.1%), Mediterranean (5.4%), Hispanic (4.8%), and others (0.8%).Primary liver disease of the new HCC cases were hepatitis C (34.2%), non-alcoholic steatohepatitis (NASH, 27.3%), hepatitis B (24.2%), alcohol (11.2%), and others (3.1%). 157 (40%) of new HCC cases were diagnosed under surveillance. Barcelona Clinic Liver Cancer staging at diagnosis was 0 in 11%, A in 18.9%, B in 29.8%, C in 30.1%, and D in 10.2%.There was a reduction in hepatitis C-related HCC since 2016. In 2016, 59% (n=23/39) of new HCC cases were related to hepatitis C vs 27% (n=17/63) in 2021. Conversely, there was an increase in NASH-related HCC, 10.3% (n=4/39) in 2016 vs 41.3% (n=26/63) in 2021. Only 28% (n=30/107) of NASH-related HCC were diagnosed on surveillance. There was a higher proportion of females in the NASH-related HCC cohort (34.6%, n=37/107) vs all HCC cases (20.4%, n=80/392).ConclusionsIn a tertiary hospital with a multi-cultural Australian cohort, the incidence of NASH-related HCC was rising and overtaking hepatitis C as the leading cause of HCC cases. Further research into the identification of at-risk groups is needed to improve outcomes.