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Inicio Annals of Hepatology O-21 EVIDENCE OF SUBOPTIMAL PUBLIC HEALTH POLICIES ON HEPATOCELLULAR CARCINOMA I...
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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Vol. 28. Issue S1.
Abstracts of the 2022 Annual Meeting of the ALEH
(March 2023)
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O-21 EVIDENCE OF SUBOPTIMAL PUBLIC HEALTH POLICIES ON HEPATOCELLULAR CARCINOMA IN THE AMERICAS: A HUGE DEBT OF OUR REGION
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Luis Antonio Díaz1, Gustavo Ayares1, Francisco Idalsoaga1, Jorge Arnold1, Blanca Norero1,2, Oscar Corsi1, Gonzalo Pizarro3, Sergio García4, Eduardo Fuentes-López5, Edmundo Martinez2, Patricia Guerra Salazar6, Roberta C. Araújo7, Mario Reis Alvares-Da-Silva8, Florencia D. Pollarsky9, Nelia Hernandez10, Juan Carlos Restrepo11, Mirtha Infante12, Enrique Carrera13, Abel Sanchez14, Marcos Girala15..., Martín Padilla16, Javier Díaz17, Martín Tagle18, Melisa Dirchwolf19, Manuel Mendizabal20, Mariana Lazo21, Catterina Ferreccio22, Thomas G. Cotter23, Mayur Brahmania24, Nahum Méndez-Sánchez25, Juan Pablo Roblero26, Winston Dunn27, Patrick S. Kamath28, Ashwani K. Singal29, Ramón Bataller30, Marco Arrese1, Juan Pablo Arab1Ver más
1 Department of Gastroenterology, Medical School, Pontifical Catholic University of Chile, Santiago, Chile
2 Gastroenterology Service, Dr. Sótero del Río Hospital, Santiago, Chile
3 Department of Hematology-Oncology, Medical School, Pontifical Catholic University of Chile, Santiago, Chile
4 Medical School, Pontifical Catholic University of Chile, Santiago, Chile
5 Department of Health Sciences, Speech-Language Pathology Department, Medical School, Pontifical Catholic University of Chile, Santiago, Chile
6 Gastroenterology Institute Bolivian-Japanese, Cochabamba, Bolivia
7 Gastroenterology Division, Ribeirão Preto Medical School, University of São Paulo, 14048-900 Ribeirão Preto, SP, Brazil
8 Clinic Hospital of Porto Alegre, Porto Alegre, Brazil
9 Hepatology Section, Gastroenterology Hospital of Dr. Carlos Bonorino Udaondo, Buenos Aires, Argentina
10 Gastroenterology Clinic, Clinic Hospital Medical School, University of República Uruguay, Montevideo, Uruguay
11 Hepatology Unit of Pablo Tobon Uribe Hospital, Gastrohepatology Group of Antioquia University, Medellín, Colombia
12 Medical Science University of La Habana, Havana, Cuba
13 Eugenio Espejo Hospital, Quito, Ecuador
14 Gastroenterology Digestive Endoscopy Hepatology, Roosevelt Hospital, Guatemala City, Guatemala
15 Gastroenterology Department, Clinic Hospital, National University of Asunción, Asunción, Paraguay
16 Mayor Nacional University of San Marcos. Guillermo Almenara National Hospital, Lima, Perú
17 Nacional Hospital Edgardo Rebagliati, Jesús María, Perú
18 Medical School Alberto Hurtado, Peruvian University Cayetano Heredia, Lima, Perú
19 Liver Unit, Private Hospital of Rosario, Rosario, Argentina
20 Hepatology and Liver Transplant Unit, Austral Universitary Hospital, Buenos Aires, Argentina
21 Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
22 Public Health Department, School of Medicine, Pontifical Catholic University of Chile, Santiago, Chile. Advanced Center for Chronic Diseases, ACCDis, Santiago, Chile
23 Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USA
24 Department of Medicine, Division of Gastroenterology, Western University, London Health Sciences Center, London, Ontario, Canada
25 Liver Research Unit, Medica Sur Clinic & Foundation, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, 14050, Mexico
26 Gastroenterology Section, Clinical Hospital of University of Chile, Medical School, University of Chile, Santiago, Chile
27 University of Kansas Medical Center, KS, USA
28 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
29 Department of Medicine, University of South Dakota Sanford School of Medicine, Division of Transplant Hepatology, Avera Transplant Institute, Sioux Falls, SD, United States
30 Center for Liver Diseases, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, PA, USA
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Vol. 28. Issue S1

Abstracts of the 2022 Annual Meeting of the ALEH

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Introduction and Objectives

Although most cases of HCC occur in patients with advanced liver disease and there are effective screening methods, health policies aimed at preventing and detecting HCC are not often on the agenda of government initiatives and policies. This study aimed to explore HCC-related population-wide public health policies, treatment availability, epidemiological surveillance, and awareness campaigns in the Americas.

Materials and Methods

We conducted a 43-item survey about HCC among experts from 12 countries. Questions were classified into four categories: policies and civil society (18 questions), clinical guidelines (5 questions), epidemiology (7 questions), and care management (13 questions). The survey was administered using an electronic form in May 2022. Data was collected in a spreadsheet, revised by two independent reviewers, and contrasted with governmental institutions.

Results

We obtained 22 responses from 15 out of the 18 countries targeted. A total of 7 (47%) countries had a written national cancer strategy or action plan. Only 4 (27%) countries had a specific written national HCC strategy or action plan, including Argentina, Brazil, Mexico, and the United States. These same four countries also had national clinical guidelines on HCC. HCC is managed by various providers, including Hepatologists (80%), Oncologists (80%), Gastroenterologists (60%), Surgeons (47%), and Palliative medicine (20%). There were important differences in the availability of treatments among countries in the Americas (Figure). Of note, 60% of countries had liver transplantation available for HCC, but only 67% of them had this therapy outside the capital city. Nine (60%) countries had a national disease registry that included HCC. However, only Brazil (7%) had governmental funded awareness campaigns on HCC prevention or screening.

Conclusions

Implementation of public health policies on HCC is scarce in the Americas. Important differences in treatments were observed across countries, especially in curative therapies. Our results strongly encourage developing public health policies on HCC in the Americas.

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