Hepatocellular carcinoma etiology evolution in an interventional radiology department of a tertiary hospital in China (2009-2023): A 1,233-case analysis
Yapan Guo, Shitao Lu, Xudong Zhang, Yu Yin, Tongqing Xue, Zhi LiABSTRACT
Background:
Hepatitis B virus (HBV) has historically been the primary cause of hepatocellular carcinoma (HCC) in China; however, recent etiological shifts due to HBV vaccination and lifestyle changes have influenced HCC prevention and management. Given the scarcity of long-term data, this study examines the etiological evolution of HCC from 2009 to 2023 using data from the interventional radiology department of a tertiary hospital to reflect broader national epidemiological trends.
Methods:
A retrospective analysis was conducted on 1,233 HCC patients diagnosed between 2009 and 2023. Patients were categorized based on viral serological status into HBV-related HCC, non-HBV non-HCV HCC (NBNC-HCC), and HCV-related HCC. Temporal, gender-specific, and age-specific distributions were analyzed.
Results:
Overall, HBV-HCC accounted for 75.3% (928/1,233) of cases, though its proportion exhibited a significant downward trend, declining from 91.0% in 2009 to 57.3% in 2022. Notably, in the most recent 5-year period (2019–2023), HBV-HCC decreased further to an average of 65.7%. Conversely, the proportion of NBNC-HCC showed a consistent upward trajectory. The proportion of NBNC-HCC was significantly higher in female patients (35.7%) compared to males (20.0%). In terms of age distribution, HBV-HCC remained dominant among younger patients (<35 years, 100.0%), whereas NBNC-HCC became the leading etiology among older patients (>65 years, 49.7%).
Conclusions:
The etiology of HCC in China is transitioning from HBV predominance toward a coexistence of HBV-related and rising NBNC-HCC, although HBV continues to dominate among younger patients.