Prevention of hepatocellular carcinoma: International recommendations, an evidence-based review
DOI:
https://doi.org/10.52611/confluencia.num2.2023.1005Keywords:
Primary Prevention, Secondary Prevention, Tertiary Prevention, Carcinoma, HepatocellularAbstract
Introduction: Hepatocellular carcinoma represents a significant health challenge worldwide and in Chile. Despite a decrease in lethality, other indicators such as mortality, incidence, and discharge rates continue to rise in the country. Objective: To conduct a literature review of international interventions at different levels of prevention for hepatocellular carcinoma, with the aim of identifying prevention strategies in Chile in the absence of national guidelines that synthesise them. Results and Discussion: Primary prevention focuses on avoiding liver cirrhosis, the main risk factor for hepatocellular carcinoma and non-alcoholic fatty liver disease. The importance of educating the population about alcohol consumption, diet, exercise, and hepatitis B and C virus infections is highlighted. The use of surveys such as the Alcohol Use Disorders Identification Test and legislation to reduce alcohol consumption is recommended. The importance of population surveillance and the identification of at-risk populations is emphasised. Early detection is crucial; screening is performed with abdominal ultrasound, and the use of alpha-fetoprotein is controversial. Computed tomography or magnetic resonance imaging is recommended for diagnosis. Treatment depends on the stage, liver function, and comorbidities of the patient. Options include resection, transplantation, ablation, and systemic therapies. Conclusion: This review underscores the importance of education, screening, and access to appropriate treatments to combat hepatocellular carcinoma and reduce its impact on public health.
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