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Background <p>Hepatocellular carcinoma (HCC) remains a major health burden in Asia. Advances in antiviral therapies are reshaping the etiological landscape of HCC. This study evaluated temporal shifts in HCC etiology across Asian countries and their clinical implications.</p> Methods <p>This multinational study analyzed 6,261 newly diagnosed HCC patients registered in the APASL Hepatology/Oncology Consortium (A-HOC) from 19 centers across seven Asian countries and regions between 2013 and 2023. Data on demographics, tumor characteristics, etiology, and treatment patterns were collected. Etiologies included hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), metabolic dysfunction-associated fatty liver disease (MAFLD), MAFLD plus excess alcoholic intake (MAFLD + eAL), autoimmune liver disease, cryptogenic, and others. Temporal trends and regional variations were assessed.</p> Results <p>In many countries, HBV remained predominant (43.3%–69.5%) and relatively stable throughout the period, while HCV showed only modest reductions. In Japan, HCV was the leading cause of HCC (33.1%), with a significant decline over time, accompanied by a rise in MAFLD-related HCC. ALD-related HCC increased in South Korea, and MAFLD-related HCC rose in Turkey. Tumor size and stage at diagnosis varied by etiology and region, affecting treatment strategies. Early-stage diagnosis was more frequent in Japan and Taiwan, whereas advanced-stage HCC was common in China and Indonesia.</p> Conclusions <p>Distinct regional patterns and temporal changes in HCC etiology across Asia highlight the need for tailored prevention and surveillance measures. The growing burden of MAFLD-related HCC emphasizes its emerging role in liver cancer development, particularly in regions with declining viral hepatitis.</p>

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Temporal trends and regional variations in hepatocellular carcinoma etiology: a multinational study across Asia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月5日

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  • Yasuto Takeuchi,
  • Ryosuke Tateishi,
  • Shuntaro Obi,
  • Motoyuki Otsuka,
  • Hitoshi Mochizuki,
  • Amarsanaa Jazag,
  • Osamu Yokosuka,
  • Sadahisa Ogasawara,
  • Naoya Kanogawa,
  • Erdenebayar Gonchig,
  • Yuki Matsushita,
  • Murat Kekilli,
  • Gulden Bilican,
  • Yoon Jun Kim,
  • Moon Haeng Hur,
  • Ming-Lung Yu,
  • Chung-Feng Huang,
  • Asahiro Morishita,
  • Kyoko Oura,
  • Atsumasa Komori,
  • Yasuhide Motoyoshi,
  • Lianda Siregar,
  • Imelda Loho,
  • Ming Yang,
  • Shuichirou Okabe,
  • Yoshiyuki Ueno,
  • Tomohiro Katsumi,
  • Takahisa Sato,
  • Hirofumi Kogure,
  • Ryota Masuzaki,
  • Cosmas Rinaldi Lesmana,
  • S. H. H. Nababan,
  • Supot Nimanong,
  • Yi-Hsiang Huang,
  • Hiroaki Nagamatsu,
  • Hideo Yoshida,
  • Koji Uchino,
  • Irsan Hasan,
  • Taya Kitiyakara,
  • Masatoshi Akamatsu,
  • Makoto Okamoto,
  • Mayuko Kondo,
  • Makoto Moriyama,
  • Wattana Sukeepaisarnjareon,
  • Pisit Tangkijvanich,
  • Kessarin Thanapirom,
  • Kendal Yalcin,
  • Hayriye Dilan Kızıl,
  • Gupse Adali,
  • Meral Akdogan,
  • Dilara Turan Gokce,
  • Yasemin Balaban,
  • Hale Gokcan,
  • Arif Mansur Coşar,
  • Murat Harputluoglu,
  • İbrahim Halil Bahçecioğlu,
  • Alp Atasoy,
  • Muhammet Cem Kockar,
  • Hakan Dursun,
  • Ahmet Tarik Eminler,
  • Jose Sollano,
  • Dong Jin Su,
  • Teerha Piratvisuth,
  • Jia-Horng Kao,
  • Darrell Crawford,
  • Jinlin Hou,
  • Barjesh Chander Sharma,
  • Diana Alcantara Payawal,
  • Rino Alvani Gani,
  • Tawesak Tanwandee,
  • Jin Mo Yang,
  • Han-Chieh Lin,
  • Shuichiro Shiina,
  • Ji-Dong Jia,
  • George Lau,
  • Necati Örmeci,
  • A. Kadir Dokmeci,
  • Lai Wei,
  • Shiv Kumar Sarin,
  • Masao Omata

摘要

Background

Hepatocellular carcinoma (HCC) remains a major health burden in Asia. Advances in antiviral therapies are reshaping the etiological landscape of HCC. This study evaluated temporal shifts in HCC etiology across Asian countries and their clinical implications.

Methods

This multinational study analyzed 6,261 newly diagnosed HCC patients registered in the APASL Hepatology/Oncology Consortium (A-HOC) from 19 centers across seven Asian countries and regions between 2013 and 2023. Data on demographics, tumor characteristics, etiology, and treatment patterns were collected. Etiologies included hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), metabolic dysfunction-associated fatty liver disease (MAFLD), MAFLD plus excess alcoholic intake (MAFLD + eAL), autoimmune liver disease, cryptogenic, and others. Temporal trends and regional variations were assessed.

Results

In many countries, HBV remained predominant (43.3%–69.5%) and relatively stable throughout the period, while HCV showed only modest reductions. In Japan, HCV was the leading cause of HCC (33.1%), with a significant decline over time, accompanied by a rise in MAFLD-related HCC. ALD-related HCC increased in South Korea, and MAFLD-related HCC rose in Turkey. Tumor size and stage at diagnosis varied by etiology and region, affecting treatment strategies. Early-stage diagnosis was more frequent in Japan and Taiwan, whereas advanced-stage HCC was common in China and Indonesia.

Conclusions

Distinct regional patterns and temporal changes in HCC etiology across Asia highlight the need for tailored prevention and surveillance measures. The growing burden of MAFLD-related HCC emphasizes its emerging role in liver cancer development, particularly in regions with declining viral hepatitis.