| Background and aims: The etiology of HCC is changing around the world. We aim to clarify the changes in etiology of HCC in Asia. Methods: Data was collected from all Asian regions by the A-HOC study. A retrospective analysis was performed on 3,196 patients (China had 195, Mongolia had 219, Turkey had 274, Indonesia had 207, and Japan had 2,301 patients) diagnosed between 2013 and 2023. Results: Median age was lowest in China at 55 years and highest in Japan at 73 years. The ratio of diabetes patients was highest in Turkey at 39.8%, followed by Japan at 33.3%. In Asia as a whole, there were no differences in the trends in the proportion of hepatitis viruses in the etiology of HCC, although hepatitis C virus patients were gradually decreasing in Japan and Turkey. In Japan and Turkey, non-alcoholic fatty liver disease patients are increasing instead. On the contrary, the ratio of hepatitis B virus patients remained high in China and Indonesia. In Japan and Turkey, the ratio of BCLC-C HCC was increasing, and systemic therapy was increasingly chosen as the first-line treatment. Conclusion: The etiology, the ratio of advanced HCC, and treatment have changed in Asia, revealed by the A-HOC study. These are fundamental information for the development of efficient interventional methods against HCC in all Asian regions. |
