Temporal trends and regional variations in hepatocellular carcinoma etiology: a multinational study across Asia
Issued Date
2026-01-01
Resource Type
ISSN
19360533
eISSN
19360541
Scopus ID
2-s2.0-105029219298
Journal Title
Hepatology International
Rights Holder(s)
SCOPUS
Bibliographic Citation
Hepatology International (2026)
Suggested Citation
Takeuchi Y., Tateishi R., Obi S., Otsuka M., Mochizuki H., Jazag A., Yokosuka O., Ogasawara S., Kanogawa N., Gonchig E., Matsushita Y., Kekilli M., Bilican G., Kim Y.J., Hur M.H., Yu M.L., Huang C.F., Morishita A., Oura K., Komori A., Motoyoshi Y., Siregar L., Loho I., Yang M., Okabe S., Ueno Y., Katsumi T., Sato T., Kogure H., Masuzaki R., Lesmana C.R., Nababan S.H.H., Nimanong S., Huang Y.H., Nagamatsu H., Yoshida H., Uchino K., Hasan I., Kitiyakara T., Akamatsu M., Okamoto M., Kondo M., Moriyama M., Sukeepaisarnjareon W., Tangkijvanich P., Thanapirom K., Yalcin K., Kızıl H.D., Adali G., Akdogan M., Gokce D.T., Balaban Y., Gokcan H., Coşar A.M., Harputluoglu M., Bahçecioğlu İ.H., Atasoy A., Kockar M.C., Dursun H., Eminler A.T., Sollano J., Su D.J., Piratvisuth T., Kao J.H., Crawford D., Hou J., Sharma B.C., Payawal D.A., Gani R.A., Tanwandee T., Yang J.M., Lin H.C., Shiina S., Jia J.D., Lau G., Örmeci N., Dokmeci A.K., Wei L., Sarin S.K., Omata M. Temporal trends and regional variations in hepatocellular carcinoma etiology: a multinational study across Asia. Hepatology International (2026). doi:10.1007/s12072-026-11037-z Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114991
Title
Temporal trends and regional variations in hepatocellular carcinoma etiology: a multinational study across Asia
Author(s)
Takeuchi Y.
Tateishi R.
Obi S.
Otsuka M.
Mochizuki H.
Jazag A.
Yokosuka O.
Ogasawara S.
Kanogawa N.
Gonchig E.
Matsushita Y.
Kekilli M.
Bilican G.
Kim Y.J.
Hur M.H.
Yu M.L.
Huang C.F.
Morishita A.
Oura K.
Komori A.
Motoyoshi Y.
Siregar L.
Loho I.
Yang M.
Okabe S.
Ueno Y.
Katsumi T.
Sato T.
Kogure H.
Masuzaki R.
Lesmana C.R.
Nababan S.H.H.
Nimanong S.
Huang Y.H.
Nagamatsu H.
Yoshida H.
Uchino K.
Hasan I.
Kitiyakara T.
Akamatsu M.
Okamoto M.
Kondo M.
Moriyama M.
Sukeepaisarnjareon W.
Tangkijvanich P.
Thanapirom K.
Yalcin K.
Kızıl H.D.
Adali G.
Akdogan M.
Gokce D.T.
Balaban Y.
Gokcan H.
Coşar A.M.
Harputluoglu M.
Bahçecioğlu İ.H.
Atasoy A.
Kockar M.C.
Dursun H.
Eminler A.T.
Sollano J.
Su D.J.
Piratvisuth T.
Kao J.H.
Crawford D.
Hou J.
Sharma B.C.
Payawal D.A.
Gani R.A.
Tanwandee T.
Yang J.M.
Lin H.C.
Shiina S.
Jia J.D.
Lau G.
Örmeci N.
Dokmeci A.K.
Wei L.
Sarin S.K.
Omata M.
Tateishi R.
Obi S.
Otsuka M.
Mochizuki H.
Jazag A.
Yokosuka O.
Ogasawara S.
Kanogawa N.
Gonchig E.
Matsushita Y.
Kekilli M.
Bilican G.
Kim Y.J.
Hur M.H.
Yu M.L.
Huang C.F.
Morishita A.
Oura K.
Komori A.
Motoyoshi Y.
Siregar L.
Loho I.
Yang M.
Okabe S.
Ueno Y.
Katsumi T.
Sato T.
Kogure H.
Masuzaki R.
Lesmana C.R.
Nababan S.H.H.
Nimanong S.
Huang Y.H.
Nagamatsu H.
Yoshida H.
Uchino K.
Hasan I.
Kitiyakara T.
Akamatsu M.
Okamoto M.
Kondo M.
Moriyama M.
Sukeepaisarnjareon W.
Tangkijvanich P.
Thanapirom K.
Yalcin K.
Kızıl H.D.
Adali G.
Akdogan M.
Gokce D.T.
Balaban Y.
Gokcan H.
Coşar A.M.
Harputluoglu M.
Bahçecioğlu İ.H.
Atasoy A.
Kockar M.C.
Dursun H.
Eminler A.T.
Sollano J.
Su D.J.
Piratvisuth T.
Kao J.H.
Crawford D.
Hou J.
Sharma B.C.
Payawal D.A.
Gani R.A.
Tanwandee T.
Yang J.M.
Lin H.C.
Shiina S.
Jia J.D.
Lau G.
Örmeci N.
Dokmeci A.K.
Wei L.
Sarin S.K.
Omata M.
Author's Affiliation
The University of Tokyo
Tsinghua University
The University of Queensland
Hacettepe Üniversitesi
Chulalongkorn University
Ankara Üniversitesi
National Taiwan University Hospital
Gazi Üniversitesi
University of Health Sciences
Taipei Veterans General Hospital
Seoul National University Hospital
Atatürk Üniversitesi
Khon Kaen University
Prince of Songkla University
Nanfang Hospital, Southern Medical University
Karadeniz Technical University
Firat Üniversitesi
Siriraj Hospital
Kaohsiung Medical University Chung-Ho Memorial Hospital
Juntendo University School of Medicine
Sakarya Üniversitesi
Süleyman Demirel Üniversitesi
Inönü Üniversitesi
Nihon University School of Medicine
Beijing Friendship Hospital, Capital Medical University
Dicle Üniversitesi
Yamagata University Faculty of Medicine
Bahçeşehir Üniversitesi
Kagawa University Faculty of Medicine
King Chulalongkorn Memorial Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Chiba University School of Medicine
Beijing Tsinghua Changgung Hospital
Govind Ballabh Pant Institute of Postgraduate Medical Education and Research
Yonsei University Health System
Japanese Red Cross Medical Center
Mitsui Memorial Hospital
Institute of Liver and Biliary Sciences
National Hospital Organization Nagasaki Medical Center
Teikyo University Chiba Medical Center
Faculty of Medicine
Yamanashi Prefectural Central Hospital
JR Tokyo General Hospital
University of Santo Tomas Hospital
Istanbul Health and Technology University
Rumah Sakit Kanker Dharmais
Matsudo City General Hospital
Humanity and Health Medical Centre
Mochtar Riyadi Comprehensive Cancer Center (MRCCC) Siloam Semanggi Hospital
Ankara Bilkent City Hospital
Daehang Hospital
Happy Veritas Liver Diagnostic Center
Fatima University Medical Center
Tsinghua University
The University of Queensland
Hacettepe Üniversitesi
Chulalongkorn University
Ankara Üniversitesi
National Taiwan University Hospital
Gazi Üniversitesi
University of Health Sciences
Taipei Veterans General Hospital
Seoul National University Hospital
Atatürk Üniversitesi
Khon Kaen University
Prince of Songkla University
Nanfang Hospital, Southern Medical University
Karadeniz Technical University
Firat Üniversitesi
Siriraj Hospital
Kaohsiung Medical University Chung-Ho Memorial Hospital
Juntendo University School of Medicine
Sakarya Üniversitesi
Süleyman Demirel Üniversitesi
Inönü Üniversitesi
Nihon University School of Medicine
Beijing Friendship Hospital, Capital Medical University
Dicle Üniversitesi
Yamagata University Faculty of Medicine
Bahçeşehir Üniversitesi
Kagawa University Faculty of Medicine
King Chulalongkorn Memorial Hospital
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Chiba University School of Medicine
Beijing Tsinghua Changgung Hospital
Govind Ballabh Pant Institute of Postgraduate Medical Education and Research
Yonsei University Health System
Japanese Red Cross Medical Center
Mitsui Memorial Hospital
Institute of Liver and Biliary Sciences
National Hospital Organization Nagasaki Medical Center
Teikyo University Chiba Medical Center
Faculty of Medicine
Yamanashi Prefectural Central Hospital
JR Tokyo General Hospital
University of Santo Tomas Hospital
Istanbul Health and Technology University
Rumah Sakit Kanker Dharmais
Matsudo City General Hospital
Humanity and Health Medical Centre
Mochtar Riyadi Comprehensive Cancer Center (MRCCC) Siloam Semanggi Hospital
Ankara Bilkent City Hospital
Daehang Hospital
Happy Veritas Liver Diagnostic Center
Fatima University Medical Center
Corresponding Author(s)
Other Contributor(s)
Abstract
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.