Hepatocellular Carcinoma (HCC) in the UAE

Abstract

The incidence of HCC in the UAE has been stable, with around 60–100 cases per year in the UAE between 2013 and 2021, with a potential future increase in incidence with rising rates of obesity, diabetes, and excessive alcohol consumption, as well as hepatitis B virus, hepatitis C virus, and nonalcoholic steatohepatitis (NASH).The age-specific incidence of HCC peaks between 80 and 90 years old, but new cases can be detected as early as 40 due to alcoholic liver disease. The prevalence of hepatitis C is low (0.1%) due to the availability of universal hepatitis B vaccination at birth. However, the incidence of HCC is expected to continue to increase due to rising obesity and diabetes.Multiple risk factors contribute to the development of HCC in the UAE, including viral hepatitis (B and C), excessive alcohol consumption, and the increasing prevalence of nonalcoholic fatty liver disease (NAFLD). The growing population and associated lifestyle changes, such as obesity and metabolic syndrome, also play a role.The diagnosis of HCC is challenging in the early stages and is typically performed through noninvasive imaging. In some cases, a biopsy may be necessary. Staging systems for HCC should take into account tumor burden, liver function, and patient performance status. The Milan criteria, used in the GCC, including the UAE, are used to determine eligibility for liver transplantation based on tumor size and spread. The availability of deceased donor organ transplantation in the UAE has enabled a total of 25 liver transplants to be performed, with 100% patient survival and 96% graft survival after a median follow-up of 647 days. No recurrence of HCC was observed in patients after transplantation.The UAE Ministry of Health and Prevention (MOHAP), the Department of Health (DOH) in Abu Dhabi, and the Dubai Health Authority (DHA) work together to provide high-quality and safe healthcare services to all citizens and residents of the UAE. The implementation of the National Agenda’s objectives, including the reduction of cancer-related mortality, is enabled by the presence of the DOH and DHA in all healthcare facilities.To mitigate the impact of HCC in the UAE, various strategies have been implemented, including liver health awareness and screening programs and multiple modalities of treatment, including surgical resection, liver transplantation, ablation therapy, radiation therapy, and chemotherapy. Additionally, the UAE has implemented policies to reduce the incidence of HCC, such as vaccination programs for hepatitis B, antiviral treatment for hepatitis C, restrictions on alcohol consumption, and measures to reduce the burden of NAFLD by promoting healthy lifestyles and reducing the consumption of unhealthy foods.