Clinical and Epidemiological Characteristics of Hepatocellular Carcinoma in the Republic of Saha (Yakutia)

Relevance. In 2016, a resolution was adopted at the 69th World Health Assembly, the goal of which is to eliminate parenteral hepatitis in the world by 2030. In the Republic of Sakha (Yakutia), as in the Russian Federation as a whole, it is necessary to determine the starting positions for the prevalence and incidence of hepatitis B, C, and D, as the leading factors in the development of hepatocellular carcinoma. Aim: to give a clinical and epidemiological characterization of hepatocellular carcinoma in the Republic of Sakha (Yakutia) at the initial stage of the program for the elimination of viral hepatitis for subsequent analysis of its effectiveness. Materials & Methods. A clinical and epidemiological analysis of morbidity, mortality, cumulative survival in hepatocellular carcinoma in the Republic of Sakha (Yakutia) over a 10-year period (2009-2018) was carried out. Predictors for the development of hepatocellular carcinoma were analyzed based on primary medical records and a survey of 125 patients. Results and discussion. The incidence rate of hepatocellular carcinoma in the Republic of Sakha (Yakutia) over the past 10 years is 2.0 3.9 times higher than the corresponding indicator in the Russian Federation. The highest mortality from the studied pathology is noted in the Central and Polar zones of the republic. According to the materials of the cancer registry, the median cumulative survival of patients with carcinoma was 13.7 months from the date of diagnosis, which is significantly higher than ten years ago. The main risk factors have been identified, among which the leading role is played by infection with hepatitis C, B, and D. viruses. Also, alcohol abuse, diabetes mellitus, overweight, and smoking are important. Conclusion. The Republic of Sakha (Yakutia) is a hyperendemic region of the Russian Federation in terms of the incidence of hepatocellular carcinoma with a predominance of the male population in its structure. The rate of decrease in the incidence of liver cancer in the country will depend on the effectiveness of the regional program for the elimination of viral hepatitis and the decrease in the incidence of cirrhosis of the liver of non-infectious etiology.

1. Pimenov NN, Komarova SV, Karandashova IV, et al. Hepatitis С and its outcomes in Russia: analysis of incidence, prevalence and mortality rates before the start of the programme of infection elimination. Infectious diseases. 2018;16(3):37-45. (In Russ). doi: 10.20953/1729-9225-2018-3-37-45

2. Merabishvili VM, Merabishvili EN, Chepik OF. Epidemiology of liver cancer. Morbidity, mortality, dynamics of histological structure. Siberian journal of oncology. 2015;2:5-14. (In Russ).

3. Breder VV, Kosyrev VY, Kudashkin NE, et al. Hepatocellular carcinoma as a social and medical problem in the Russian Federation. Meditsinskiy sovet. 2016; 10:10-8. (In Russ.). doi:10.21518/2079-701X-2016-10-10-16.

4. Yang JD, Hainaut P, Gores GJ, et al. A global view of hepatocellular carcinoma: trends, risk, prevention and management. Nat Rev Gastroenterol Hepatol. 2019;16(10):589-604.

5. Massarweh NN, El-Serag HB. Epidemiology of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Cancer Control. 2017 Jul-Sep;24(3):1073274817729245. doi: 10.1177/1073274817729245.

6. Mittal S, El-Serag HB. Epidemiology of hepatocellular carcinoma: consider the population [abstract]. J Clin Gastroenterol. 2013;47: S2-6.

7. Sleptsova SS. Parenteral viral hepatitis and their origin in the Republic of Sakha (Yakutia). Moscow, 2017: Chekhovskii pechatnii dvor; 208. (In Russ.).

8. Sleptsova SS, Bilyukina IF. Predictors development of hepatocellular carcinoma of patients with chronic viral hepatitis in the Republic of Sakha (Yakutia). Infectious diseases: news, opinions, education. 2019;8(1):28-33. (In Russ).

9. Rekomendatsii po diagnostike i lecheniyu vzroslykh bol'nykh gepatitami B i C: Klinicheskie rekomendatsii. Ed.: Ivashkin VT, Yushchuk ND. Moscow: Izdatel'stvo «GEOTAR-Media»; 2015. (In Russ).

10. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subject. JAMA. 2013;310(20):2191-2194.

11. Babor T, Higgins-Biddle JC, Saunders JB, et al. (2001). AUDIT - The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care (2nd edn). Geneva: World Health Organization.

12. Kim HS, El-Serag HB. The Epidemiology of hepatocellular carcinoma in the USA. Curr Gastroenterol Rep. 2019;2(4):17.

13. El-Serag HB. Epidemiology of viral hepatitis and hepatocellular carcinoma.Gastroenterology. 2012;142 (6):1264-1273.e1.

14. Agyemang-Yeboah F, Eghan BAJ, Annani-Akollor ME, et al. Evaluation of metabolic syndrome and its associated risk factors in type 2 diabetes: a descriptive cross-sectional study at the komfo anokye teaching hospital, Kumasi, Ghana. Biomed Res Int. 2019. https://doi.org/10.1155/2019/4562904.

15. Ioannou GN, Green P, Lowy E, et al. Differences in hepatocellular carcinoma risk, predictors and trends over time according to etiology of cirrhosis. PLoS One. 2018;13(9):e0204412.

16. Ivashkin VT, Mayev IV, Kaprin AD, et al. Early detection of oncological diseases of the digestive system (methodological guide of the Russian Gastroenterological Association and the Association of Russian Oncologists for primary care physicians). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2019;29(50):53-74.