%0 Journal Article
%T Africa Guidelines for Hepatocellular Carcinoma Buildup Process.
%A Abou-Alfa GK
%A Afihene M
%A Capanu M
%A Li Y
%A Chou JF
%A Asombang A
%A Alatise OI
%A Bounedjar A
%A Cunha L
%A Mekonnen HD
%A Diop PS
%A Elwakil R
%A Ali MM
%A Ndlovu N
%A Ndumbalo J
%A Makondi PT
%A Tzeuton C
%A Biachi de Castria T
%A Agyei-Nkansah AA
%A Balogun F
%A Bougouma A
%A Atipo Ibara BI
%A Jonas E
%A Kimani S
%A Kingham P
%A Kurrimbukus R
%A Hammad N
%A Fouad M
%A El Baghdady N
%A Servais Albert Fiacre EB
%A Sewram V
%A Spearman CW
%A Yang JD
%A Roberts LR
%A Abdelaziz AO
%J JCO Glob Oncol
%V 9
%N 0
%D 2023 Sep
%M 37944087
暂无%R 10.1200/GO.23.00159
%X <B>OBJECTIVE: </B>Hepatocellular carcinoma (HCC), the fourth most common cancer in Africa, has a dismal overall survival of only 3 months like in sub-Saharan Africa. This is affected by the low gross domestic product and human development index, absence of coherent guidelines, and other factors.<BR><B>METHODS: </B>An open forum for HCC-experienced health care workers from Africa and the rest of the world was held in October 2021. Participants completed a survey to help assess the real-life access to screening, diagnoses, and treatment in the North and Southern Africa (NS), East and West Africa (EW), Central Africa (C), and the rest of the world.<BR><B>RESULTS: </B>Of 461 participants from all relevant subspecialties, 372 were from Africa. Most African participants provided hepatitis B vaccination and treatment for hepatitis B and C. More than half of the participants use serum alpha-fetoprotein and ultrasound for surveillance. Only 20% reported using image-guided diagnostic liver biopsy. The Barcelona Clinic Liver Cancer is the most used staging system (52%). Liver transplant is available for only 28% of NS and 3% EW. C reported a significantly lower availability of resection. Availability of local therapy ranged from 94% in NS to 62% in C. Sorafenib is the most commonly used systemic therapy (66%). Only 12.9% reported access to other medications including immune checkpoint inhibitors. Besides 42% access to regorafenib in NS, second-line treatments were not provided.<BR><B>CONCLUSIONS: </B>Similarities and differences in the care for patients with HCC in Africa are reported. This reconfirms the major gaps in access and availability especially in C and marginally less so in EW. This is a call for concerted multidisciplinary efforts to achieve and sustain a reduction in incidence and mortality from HCC in Africa.