title: Hepatocellular Carcinoma in Pakistan: National Trends and Global Perspective.
abstract: Hepatocellular carcinoma (HCC) ranks second amongst all causes of cancer deaths globally. It is on a rise in Pakistan and might represent the most common cancer in adult males. Pakistan contributes significantly to global burden of hepatitis C, which is a known risk factor for HCC, and has one of the highest prevalence rates (>3%) in the world. In the absence of a national cancer registry and screening programs, prevalence of hepatitis and HCC only represents estimates of the real magnitude of this problem. In this review, we present various aspects of HCC in Pakistan, comparing and contrasting it with the global trends in cancer care. There is a general lack of awareness regarding risk factors of HCC in Pakistani population and prevalence of hepatitis C has increased. In addition, less common risk factors are also on a rise. Majority of patients present with advanced HCC and are not eligible for definitive treatment. We have attempted to highlight issues that have a significant bearing on HCC outcome in Pakistan. A set of strategies have been put forth that can potentially help reduce incidence and improve HCC outcome on national level.
authors.affiliation: Department of HPB and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Abu Bakar
authors.initials: AB
authors.lastname: Hafeez Bhatti
authors.affiliation: Department of HPB and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Faisal Saud
authors.initials: FS
authors.lastname: Dar
authors.affiliation: Sind Medical College, Karachi, Pakistan.
authors.forename: Anum
authors.initials: A
authors.lastname: Waheed
authors.affiliation: Department of Public Health, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Kashif
authors.initials: K
authors.lastname: Shafique
authors.affiliation: Department of Infectious Diseases, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
authors.forename: Faisal
authors.initials: F
authors.lastname: Sultan
authors.affiliation: Department of Transplant Hepatology and Gastroenterology, Shifa International Hospital, Islamabad, Pakistan.
authors.forename: Najmul Hassan
authors.initials: NH
authors.lastname: Shah