ArticleHepatology international2026
Contemporary epidemiology and real-world management of hepatocellular carcinoma (HCC) in Australia: insights from a prospective Australian National Clinical Quality Registry.
Article in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
aimsHepatocellular carcinoma (HCC) is a rapidly increasing healthcare burden in Australia. We aimed to evaluate the contemporary epidemiology, clinical characteristics, and real-world patterns of care for HCC in Australia using a prospective multicentre clinical quality registry.
methodsThis interim analysis utilised data from the Upper Gastrointestinal Cancer Registry (UGICR) HCC module, a multicentre clinical quality registry involving 17 major centres across all mainland Australian states. Patients with a new diagnosis of HCC from 1 January 2021 were included. Clinical characteristics and initial treatment modalities were compared between liver transplant centres (LTCs) and non-transplant centres (NTCs).
resultsA total of 489 patients were analysed (333 LTC, 156 NTC). The cohort was predominantly male (76.7%) with a median age of 67.0 years. Compared to historical data, a marked shift in etiology was observed, with HCV-related HCC declining to 14.1%, while metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-related disease emerged as leading contributors with 61.7% patients identified as affected by steatotic liver disease. Overall, 56.9% of patients presented with early-stage disease (BCLC 0/A). Across the entire cohort of patients with HCC, 42.9% detected after surveillance. In those with BCLC-A disease, LTCs were more likely to utilise initial TACE (36.0% vs. 16.4%; p = 0.021), whereas NTCs favoured upfront ablation. In BCLC-D patients, NTCs relied more heavily on supportive care (66.7% vs. 30.6%; p = 0.019) in contrast to LTC patients who were more likely to receive disease modifying treatment.
conclusionsMASLD is emerging as the leading cause of HCC while surveillance uptake remains suboptimal highlighting the importance of both at-risk MASLD case identification and the development of centralised HCC screening for improving the health of Australians. The significant variations in treatment patterns between LTCs and NTCs require further investigation and may provide insights that could lead to targeted quality improvement initiatives.
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