Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;55(3):1333-1344.
doi: 10.1007/s12029-024-01089-5. Epub 2024 Jul 12.

Hepatocellular Carcinoma in Asia: Physician and Patient Perspectives on Surveillance, Diagnosis, and Treatment

Rosmawati Mohamed #  1 , Wendy Wang #  2 , Tawesak Tanwandee  3 , Irsan Hasan  4 , Cam Phuong Pham  5 , Young-Suk Lim  6 , Sheng-Nan Lu  7 , Murallitharan Munisamy  8 , Thi Thanh Huong Tran  9 , Evy Ratnawati  10 , Wattana Sukeepaisarnjaroen  11 , Mahir Karababa  12 , Chee-Kiat Tan  13
Affiliations

Hepatocellular Carcinoma in Asia: Physician and Patient Perspectives on Surveillance, Diagnosis, and Treatment

Rosmawati Mohamed et al. J Gastrointest Cancer. 2024 Sep.

Abstract

Purpose: In several Asian countries, hepatocellular carcinoma (HCC) is a leading cause of cancer deaths. HCC risk factors in Asia differ from those elsewhere and are changing with the treatment landscape as systemic treatment options increase. This study was conducted to gain insight from physicians and patients into HCC screening, diagnosis, and treatment strategies in Indonesia, Korea, Malaysia, Singapore, Taiwan, Thailand, and Vietnam.

Methods: Two cross-sectional, anonymized, online surveys were completed between July and December 2022 by physicians diagnosing and treating HCC (55 questions on risk factors, surveillance, diagnosis, and treatment) and patients ≥ 18 years old diagnosed with HCC (36 questions on disease knowledge, quality of life, and experiences of diagnosis and treatment).

Results: Responses were received from 276 physicians in all 7 countries and 130 patients in Thailand, Taiwan, and Vietnam. From the physician's perspective, surveillance programs are widespread but identify insufficient HCC cases; only 18% are early-stage HCC at diagnosis. From the patient's perspective, knowledge of risk factors increases after diagnosis, but few seek support from patient associations; patients would benefit from better communication from their doctors. Treatment affordability and side effects are key issues for patients.

Conclusions: Awareness of the risk factors for HCC should be raised in primary care and the general population, and surveillance should identify early-stage HCC. Because patients rely on their doctors for support, doctors should better understand their patients' needs, and patients could be supported by trained nurses or case managers. Programs are needed to increase patients' access to proven HCC treatments.

Keywords: Asia; Diagnosis; Hepatocellular Carcinoma; Surveys and questionnaires; Therapeutics.

PubMed Disclaimer

Conflict of interest statement

Irsan Hasan, Mahir Karababa, Rosmawati Mohamed, Evy Ratnawati, Wattana Sukeepaisarnjaroen, Tawesak Tanwandee, Tran Thi Thanh Huong, and Wendy Wang declare that they have no relevant financial or non-financial interests to disclose. Young-Suk Lim has received grants or contracts; consulting fees; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events; payment for expert testimony; and support for attending meetings or travel from Gilead Sciences. Sheng-Nan Lu and Cam Phuong Pham have received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Bayer, MSD, and Roche. Murallitharan Munisamy has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astra-Zeneca, MSD, and Pfizer; receives a salary from the National Cancer Society Malaysia and has an unpaid leadership or fiduciary role in the Malaysian Medical Association Public Health Society; and holds stock or stock options in Sanofi; his institution has received grants or contracts from Astellas Pharma Inc. and MSD. Chee-Kiat Tan has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Abbott Laboratories, Astellas, Eisai, Gilead Sciences, and Roche Diagnostics; support for attending meetings or travel from Gilead Sciences; and fees for his participation on a Data Safety Monitoring Board or Advisory Board from Abbott Laboratories, Eisai, Gilead Sciences, and Roche Diagnostics.

Figures

Fig. 1
Fig. 1
Development, validation, and administration of the survey
Fig. 2
Fig. 2
Diagnostic methods used for surveillance and diagnosis of HCC in Asia. CT, computed tomography; MRI, magnetic resonance imaging
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Roadmap for HCC Surveillance and Management in the Asia Pacific.
    Kudo M, Oanh BT, Chen CJ, Ngat DT, George J, Kim DY, Pimsawadi L, Tangkijvanich P, Pwu RF, Mohamed R, Bunnag S, Lu SN, Kudtiyakarn S, Kanto T, Piratvisuth T, Wu CC, Sarno R; APAC Liver Disease Alliance. Kudo M, et al. Cancers (Basel). 2025 Jun 10;17(12):1928. doi: 10.3390/cancers17121928. Cancers (Basel). 2025. PMID: 40563580 Free PMC article.

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49. 10.3322/caac.21660. 10.3322/caac.21660 - DOI - PubMed
    1. Zhang CH, Cheng Y, Zhang S, Fan J, Gao Q. Changing epidemiology of hepatocellular carcinoma in Asia. Liver Int. 2022;42:2029–41. 10.1111/liv.15251. 10.1111/liv.15251 - DOI - PubMed
    1. Chen LT, Martinelli E, Cheng AL, Pentheroudakis G, Qin S, Bhattacharyya GS, Ikeda M, Lim HY, Ho GF, Choo SP, Ren Z, Malhotra H, Ueno M, Ryoo BY, Kiang TC, Tai D, Vogel A, Cervantes A, Lu SN, Yen CJ, Huang YH, Chen SC, Hsu C, Shen YC, Tabernero J, Yen Y, Hsu CH, Yoshino T, Douillard JY. Pan-Asian adapted ESMO clinical practice guidelines for the management of patients with intermediate and advanced/relapsed hepatocellular carcinoma: a TOS-ESMO initiative endorsed by CSCO, ISMPO, JSMO, KSMO, MOS and SSO. Ann Oncol. 2020;31:334–51. 10.1016/j.annonc.2019.12.001. 10.1016/j.annonc.2019.12.001 - DOI - PubMed
    1. Li J, Zou B, Yeo YH, Feng Y, Xie X, Lee DH, Fujii H, Wu Y, Kam LY, Ji F, Li X, Chien N, Wei M, Ogawa E, Zhao C, Wu X, Stave CD, Henry L, Barnett S, Takahashi H, Furusyo N, Eguchi Y, Hsu YC, Lee TY, Ren W, Qin C, Jun DW, Toyoda H, Wong VW, Cheung R, Zhu Q, Nguyen MH. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2019;4:389–98. 10.1016/S2468-1253(19)30039-1. 10.1016/S2468-1253(19)30039-1 - DOI - PubMed
    1. Goh GB, Chang PE, Tan CK. Changing epidemiology of hepatocellular carcinoma in Asia. Best Pract Res Clin Gastroenterol. 2015;29:919–28. 10.1016/j.bpg.2015.09.007. 10.1016/j.bpg.2015.09.007 - DOI - PubMed

MeSH terms

LinkOut - more resources