title: Incidence of hepatocellular carcinoma among Indian patients with cirrhosis of liver: an experience from a tertiary care center in northern India.
abstract: OBJECTIVE
  Despite bearing the main burden of HCC, prospective studies from developing countries are lacking. This prospective observational study was designed to estimate the incidence of HCC among Indian patients with hepatic cirrhosis.
  
  
  METHODS
  Between April 2001 and November 2004, we enrolled 301 patients with liver cirrhosis. Patients found to be free of HCC using baseline abdominal ultrasound, triple-phase computed tomography (TPCT) and serum alpha-fetoprotein (AFP) levels were followed up prospectively for detection of HCC using ultrasound and AFP every 6 months, and TPCT annually.
  
  
  RESULTS
  Among the 194 patients (mean age [SD] 45.1 [+/-13.1] years; male:female 6.1:1.0) followed up, 154 had Child's A and 40 had Child's B disease. The causes of cirrhosis were: hepatitis B-71 (36.6%), hepatitis C-54 (27.8%), dual infection with hepatitis B and C-12 (6.2%) and others including autoimmune, alcoholic and cryptogenic cirrhosis 57 (29.4%). During a cumulative follow up period of 563.4 person-years, 9 cases of HCC were detected, with an incidence rate of 1.60 per 100 person-years.
  
  
  CONCLUSIONS
  In our study, the incidence of HCC among patients with liver cirrhosis was intermediate, being lower than that in Japan but higher than that reported from Europe.
authors.affiliation: Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shashi Bala
authors.initials: SB
authors.lastname: Paul
authors.forename: Vishnubhatla
authors.initials: V
authors.lastname: Sreenivas
authors.forename: Manpreet Singh
authors.initials: MS
authors.lastname: Gulati
authors.forename: Kaushal
authors.initials: K
authors.lastname: Madan
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Gupta
authors.forename: Sima
authors.initials: S
authors.lastname: Mukhopadhyay
authors.forename: Subrat Kumar
authors.initials: SK
authors.lastname: Panda
authors.forename: Subrat Kumar
authors.initials: SK
authors.lastname: Acharya
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D014408:Biomarkers, Tumor