Journal article
O-21 EVIDENCE OF SUBOPTIMAL PUBLIC HEALTH POLICIES ON HEPATOCELLULAR CARCINOMA IN THE AMERICAS: A HUGE DEBT OF OUR REGION
Annals of hepatology, v 28, p101031
Mar 2023
Abstract
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.
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.
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.
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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Details
- Title
- O-21 EVIDENCE OF SUBOPTIMAL PUBLIC HEALTH POLICIES ON HEPATOCELLULAR CARCINOMA IN THE AMERICAS: A HUGE DEBT OF OUR REGION
- Creators
- Luis Antonio Díaz - Pontifical Catholic University of ChileGustavo Ayares - Pontifical Catholic University of ChileFrancisco Idalsoaga - Pontifical Catholic University of ChileJorge Arnold - Pontifical Catholic University of ChileBlanca Norero - Pontifical Catholic University of ChileOscar Corsi - Pontifical Catholic University of ChileGonzalo Pizarro - Pontifical Catholic University of ChileSergio García - Pontifical Catholic University of ChileEduardo Fuentes-López - Pontifical Catholic University of ChileEdmundo Martinez - Gastroenterology Service, Dr. Sótero del Río Hospital, Santiago, ChilePatricia Guerra Salazar - Gastroenterology Institute Bolivian-Japanese, Cochabamba, BoliviaRoberta C. Araújo - University of Sao PauloMario Reis Alvares-Da-Silva - Clinic Hospital of Porto Alegre, Porto Alegre, BrazilFlorencia D. Pollarsky - Hepatology Section, Gastroenterology Hospital of Dr. Carlos Bonorino Udaondo, Buenos Aires, ArgentinaNelia Hernandez - Gastroenterology Clinic, Clinic Hospital Medical School, University of República Uruguay, Montevideo, UruguayJuan Carlos Restrepo - Hepatology Unit of Pablo Tobon Uribe Hospital, Gastrohepatology Group of Antioquia University, Medellín, ColombiaMirtha Infante - Medical Science University of La Habana, Havana, CubaEnrique Carrera - Eugenio Espejo Hospital, Quito, EcuadorAbel Sanchez - Roosevelt HospitalMarcos Girala - Gastroenterology Department, Clinic Hospital, National University of Asunción, Asunción, ParaguayMartín Padilla - Mayor Nacional University of San Marcos. Guillermo Almenara National Hospital, Lima, PerúJavier Díaz - Nacional Hospital Edgardo Rebagliati, Jesús María, PerúMartín Tagle - Medical School Alberto Hurtado, Peruvian University Cayetano Heredia, Lima, PerúMelisa Dirchwolf - Liver Unit, Private Hospital of Rosario, Rosario, ArgentinaManuel Mendizabal - Hepatology and Liver Transplant Unit, Austral Universitary Hospital, Buenos Aires, ArgentinaMariana LazoCatterina Ferreccio - Pontifical Catholic University of ChileThomas G. Cotter - Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas, USAMayur Brahmania - University of LondonNahum Méndez-Sánchez - Universidad Nacional Autónoma de MéxicoJuan Pablo Roblero - University of ChileWinston Dunn - University of Kansas Medical CenterPatrick S. Kamath - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAAshwani K. Singal - University of South DakotaRamón Bataller - University of Pittsburgh Medical CenterMarco Arrese - Pontifical Catholic University of ChileJuan Pablo Arab - Pontifical Catholic University of Chile
- Publication Details
- Annals of hepatology, v 28, p101031
- Publisher
- Elsevier España, S.L.U
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Other Identifier
- 991020550346204721