Liver cancer among patients with liver cirrhosis of viral etiology: the first results of newly introduced screening program in Semey, Kazakhstan

Rakhypbekov, Tolebay

Liver cancer among patients with liver cirrhosis of viral etiology: the first results of newly introduced screening program in Semey, Kazakhstan

Tuesday, 19 August 2014

Exhibit hall (Dena'ina Center)

Tolebay Rakhypbekov, PhD , Semey State Medical University, Semey, Kazakhstan

Meruyert Massabayeva, MD , Semey State Medical University, Semey, Kazakhstan

Nurlan Aukenov, MD , Semey State Medical University, Semey, Kazakhstan

Zhanna Mussazhanova, MD , Semey State Medical University, Semey, Kazakhstan

Erbol Smail, MD , Semey State Medical University, Semey, Kazakhstan

Anargul Mansurova, MD , Semey State Medical University, Semey, Kazakhstan

Meruert Khamitova, MD , Semey State Medical University, Semey, Kazakhstan

BZ Kurmanova, MD , Semey State Medical University, Semey, Kazakhstan

Aisulu Saimova, MD , Semey State Medical University, Semey, Kazakhstan

Andrej M Grjibovski, PhD , Northern State Medical University, Arkhangelsk, Russia

INTRODUCTION: Liver cancer is the fifth most common cancer among men and the eighth most common cancer among women worldwide representing 6% of all cancers in 2009. The incidence of liver cancer has been shown to increase in developing countries including former Soviet Republics of Central Asia. Therefore, screening for liver cancer was introduced in Kazakhstan from 2013 in a few pilot regions. We present the first results of the introduction of the screening program in the Semey region (East Kazakhstan).

METHODS: All cases with newly established diagnosis of liver cirrhosis of viral etiology in 2013 aged 18-70 years were screened for liver cancer using serum alpha-fetoprotein measurements. Abnormal levels of AFP were considered as an indicator of liver cancer requiring using further diagnostic procedures. Dichotomous data are presented as proportions with 95% exact binomial confidence intervals.

RESULTS: Altogether, 40 men and 31 women with newly established diagnosis of liver cirrhosis of viral etiology were screened during the study period. The mean age of women was 53.6 years while the mean age of men was 48.8 years. Elevated levels of AFP were observed in 11.3% (95% CI: 5.0-21.0) of cases with subsequently confirmed cancer. The overall incidence of liver cancer in Semey decreased from 4.3 per 100,000 in 2009 to 3.5 per 100,000 in 2013 while mortality slightly increased from 4.4 to 4.5 per 100,000 during the same period.

CONCLUSIONS: Introduction of liver cancer screening has not resulted in either increase in the incidence or in the proportion of cases of liver cancer diagnosed in early stage in the city of Semey. Data from other pilot sites in Kazakhstan should be analyzed before making a decision regarding introduction of nation-wide screening for liver cancer. Pros and cons of screening for liver cancer in Kazakhstan will be discussed.