P5954 - Temporal Trends in the Etiology of Liver Cancer in the Middle East and North Africa Over the Past 3 Decades

Ahmed A. Abdulelah, MD¹, Mohammad Alqaisieh, MD², Zaid Al-Fakhouri, MD³, Laith Alomari, MD⁴, Zaid A. Abdulelah, MD⁵, Amer Khatib, MD⁶
1Royal Papworth Hospital, Cambridge, England, United Kingdom; 2Hamilton Health Care System, Dalton, GA; 3Case Western Reserve University / MetroHealth, Cleveland, OH; 4Thomas Jefferson University, Philadelphia, PA; 5Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, United Kingdom; 6University of Jordan, Amman, 'Amman, Jordan

Introduction: Liver cancer imposes a significant global health burden due to the associated morbidity and mortality. Different etiologies of liver cancer exists such as hepatitis B, hepatitis C, metabolic dysfunction-associated steatohepatitis (MASH), and alcohol-associated liver disease (ALD). Accordingly, evaluating the trends in the etiology of liver cancer in the Middle East and North Africa (MENA) region is of vital importance as it enables risk stratification.

Methods: Data from the Global Burden of Disease database was retrieved to evaluate the trends in the age-standardized incidence rate (ASIR) of liver cancer due to hepatitis B, hepatitis C, MASH, and ALD in the MENA region for the period 1990-2019. The Annual Percent Change (APC) and the Average Annual Percent Change (AAPC) were calculated using Joinpoint analysis. Stratification by gender was performed to evaluate for any differences between males and females.

Results: Over the past 3 decades, an estimated total of 374,348 liver cancer cases were reported in the MENA region. The leading etiology was hepatitis C (51.6%) followed by hepatitis B (28.7%), MASH (10.6%) and ALD (9.1%). A statistically significant decline in the ASIR of liver cancer due to hepatitis C was noted in the MENA region with an AAPC of -0.04 (95%CI -0.06 to -0.02, p< 0.001). Similarly, liver cancer due to hepatitis B experienced a statistically significant decline in the ASIR (AAPC -0.12, 95%CI -0.15 to -0.09, p< 0.001). Liver cancer due to MASH witnessed a statistically significant increase in the ASIR (AAPC 1.59, 95%CI 1.57 to 1.62, p< 0.001). Regarding liver cancer due to ALD, a statistically significant incline in the ASIR was noted (AAPC 0.73, 95%CI 0.71 to 0.75, p< 0.001). Interestingly, stratification by gender revealed contrasting trends between both genders in liver cancer due to hepatitis B, hepatitis C, and ALD where males were found to experience a statistically significant increase in the ASIR while females experienced a statistically significant decline. However, both males and females experienced a statistically significant increase in the ASIR of liver cancer due to MASH with an AAPC of 2.26 and 1.02, respectively.

Discussion: Overall, the MENA region witnessed a significant decline in the incidence of liver cancer due to viral hepatitis while also experiencing an increase in the incidence of liver cancer due to ALD and MASH. Gender differences pose a significant concern that mandates further evaluation.

Disclosures:
Ahmed Abdulelah indicated no relevant financial relationships.
Mohammad Alqaisieh indicated no relevant financial relationships.
Zaid Al-Fakhouri indicated no relevant financial relationships.
Laith Alomari indicated no relevant financial relationships.
Zaid Abdulelah indicated no relevant financial relationships.
Amer Khatib indicated no relevant financial relationships.

Ahmed A. Abdulelah, MD¹, Mohammad Alqaisieh, MD², Zaid Al-Fakhouri, MD³, Laith Alomari, MD⁴, Zaid A. Abdulelah, MD⁵, Amer Khatib, MD⁶. P5954 - Temporal Trends in the Etiology of Liver Cancer in the Middle East and North Africa Over the Past 3 Decades, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.