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Annals of Hepatology
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Inicio Annals of Hepatology O-13 SUB-OPTIMAL GLOBAL PUBLIC HEALTH POLICIES AND STRATEGIES TO TACKLE HEPATOCE...
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Vol. 29. Núm. S1.
Abstracts of the 2023 Annual Meeting of the ALEH
(febrero 2024)
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Vol. 29. Núm. S1.
Abstracts of the 2023 Annual Meeting of the ALEH
(febrero 2024)
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O-13 SUB-OPTIMAL GLOBAL PUBLIC HEALTH POLICIES AND STRATEGIES TO TACKLE HEPATOCELLULAR CARCINOMA
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Luis Antonio Díaz1, Eduardo Fuentes1, Blanca Norero2, Oscar Corsi1, Gustavo Ayares1, Francisco Idalsoaga1, Gonzalo Pizarro3, Sergio García1, Valeria Vázquez4, Lucas Lacalle1, Jorge Arnold1, Mariana Lazo5, Catterina Ferreccio1, Manuel Mendizabal6, Federico Piñero6, Juan Ignacio Marín7, Benyam Addissie8, Ifeorah Ijeoma9, Alexandre Louvet10, Salvatore Piano11..., Helena Cortez- Pinto12, Vincent Wong13, Anand V. Kulkarni14, Thomas G. Cotter15, Mayur Brahmania16, Winston Dunn17, Patrick S. Kamath18, Ashwani K. Singal19, José Debes20, María Reig21, Rohit Loomba22, Ramón Bataller21, Jeffrey V. Lazarus23, Marco Arrese1, Juan Pablo Arab24, OMEGA Collaborators 25Ver más
1 Department of Gastroenterology, Pontificia Universidad Católica de Chile, Santiago, Chile
2 Servicio de Gastroenterología, Hospital Dr. Sótero del Río, Santiago, Chile
3 Bradford Hill, Santiago, Chile
4 School of Medicine, Instituto Tecnológico de Monterrey, Monterrey, México
5 Department of Community Health and Prevention & Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Estados Unidos (EEUU)
6 Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Buenos Aires, Argentina
7 Hospital Pablo Tobón Uribe, Medellín, Colombia
8 Division of Gastroenterology and Hepatology, Geisinger Medical Center, Pensilvania, Estados Unidos
9 University of Nigeria Centre of Excellence for Clinical Trials, Nsukka, Nigeria
10 Services des Maladies de l'Appareil Digestif, Hôpital Claude Huriez, Lille, Francia
11 Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine, University of Padua, Padova, Italia
12 Clínica Universitária de Gastrenterologia, Laboratório de Nutrição, Universidade de Lisboa, Lisoba, Portugal
13 Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong
14 Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India
15 Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Texas, Estados Unidos
16 Univeristy of Calgary, Alberta, Canadá
17 University of Kansas Medical Center, Kansas, Estados Unidos
18 Mayo Clinic, Minnesota, Estados Unidos
19 Department of Medicine, University of South Dakota Sanford School of Medicine, South Dakota, Estados Unidos
20 Department of Medicine, University of Minnesota, Minnesota, Estados Unidos
21 Barcelona Clinic Liver Cancer group, Liver Unit, IDIBAPS, Hospital Clínic, Barcelona, España
22 NAFLD Research Center, University of California at San Diego, California, Estados Unidos
23 CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, Estados Unidos
24 Division of Gastroenterology, Department of Medicine, Western University & London Health Sciences Centre, Ontario, Canadá
25 Observatorio Multicéntrico de Enfermedades Gastrointestinales (OMEGA), Santiago, Chile
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Vol. 29. Núm S1

Abstracts of the 2023 Annual Meeting of the ALEH

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Introduction and Objectives

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. We aimed to explore HCC-related population-wide public health policies (PHP) worldwide.

Materials and Methods

We conducted a 43-item survey about HCC: policies and civil society (18 questions), clinical guidelines (5 questions), epidemiology (7 questions), and care management (13 questions). The survey was completed electronically (2022–2023). Data were collected in a spreadsheet, revised by two independent reviewers, and verified with governmental institutions, regulatory agencies, scientific societies, and scientific publications. We classified policies into eight dimensions, including criteria for low, moderate, and strong PHP establishment. We estimated an index using multiple correspondence analysis.

Results

We obtained 134 responses from 66 countries/territories (Africa N=16, the Americas N=18, Asia N=10, Europe N=21, and Oceania N=1). The median index was 43.7 [IQR: 30.9–59.3]. The lower scores were observed in Sierra Leone (0), Lebanon (5.5), and Pakistan (5.5), while Italy (79.7), Brazil (94.1), and Sweden (100) obtained the highest scores (Figure). In particular, 46 (69.7%) countries had a written national cancer strategy or action plan, but only 5 (7.6%) had a specific written national strategy or action plan on HCC. Thirty-two (48.5%) countries had national clinical practice guidelines on HCC and 54 (81.8%) countries had a national disease registry that included HCC. The most common strategies for staging HCC were Barcelona Clinic Liver Cancer (BCLC)(85%) and TNM classification (10%). The survey reflects important differences in the availability of treatments, including surgery (98.4%), tyrosine kinase inhibitors (95.1%), chemoembolization (85.2%), radiofrequency or alcohol ablation (82%), immunotherapy plus anti-VEGF (82%), liver transplant (74.2%), stereotactic body radiation therapy (42.6%), and radioembolization (36.4%).

Conclusions

The existence of PHP on HCC is insufficient worldwide. The most common strategy for staging is BCLC, but there are important differences in treatment availability across countries, especially regarding curative therapies.

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