Hepatocellular Carcinoma in Albania: Incidence and Risk Factors

Background Hepatocellular carcinoma represent a challenging malignancy of worldwide importance. Aim To assess the incidence and the potential impact of the risk factors. Methods It was a hospital-based case-control study of 648 HCC patients between January 2000 and November 2014. The age-adjusted incidence rates were calculated for 5-years period. Liver cirrhosis was designed by biopsy or in the presence of unequivocal clinico-biochemical and ultrasonographic data. HCC was defined in cirrhotic subjects by CT or MRI. For subjects without cirrhosis cytological confirmation was mandatory. Results Study population comprised 527 ( 77.1 %) males and 157 ( 22.9 %) female, given MF ratio of 3.41. The mean age of all patients was 60.4 years, with majority of them ( 70 %) between 50 and 70 years. Underlying cirrhosis was present in 89.3 % of cases, and 68 % of them were Child-Pugh class A. The overall age-adjusted incidence rates started to increase in 2010, from 6.6 and 7.4 per 100 000 population in 2000 and 2005 respectively, to 8.9 in 2010 and 9.3 in 2014, nearly 4 times higher in man than in women. The greater incidence occurred in patients 60 and 70 years of age.50.9 % of all cases were associated with HBV infection, 21.8 % with concomitant HBV infection and alcoholism, 13.8 % with alcoholic alone, 8 % with HCV infection, and 4.9 % were HCC patients with not a reliable risk factor. Conclusions The incidence rates of HCC has almost doubled in Albania between 2000 and 2014. HBV infection and heavy alcohol consumption significantly influenced for the increased incidence of HCC in our country.