Abstract 29: Toward Early Detection: A Scoping Review of Hepatocellular Cancer Surveillance in Sub-Saharan Africa

Abstract

Abstract Purpose: Hepatocellular Carcinoma (HCC) is a significant cause of cancer related mortality in Sub- Saharan Africa (SSA). Despite the potential of surveillance to improve early detection and survival amongst high-risk patients, its implementation remains limited. We aimed to examine existing HCC surveillance practices in SSA, highlight barriers to its implementation and provide recommendations for improvement. Methods: A comprehensive string search of databases such as AJOL, PubMed, EMBASE and Cochrane was conducted. Studies were limited to adult populations while post-symptomatic diagnosis was excluded. Data extraction, synthesis and analysis adhered to PRISMA-ScR guidelines, with independent review processes to ensure rigor. Results: 8 studies were included, with a time span ranging from 2020 to 2024. Only 1 study reported data from rural settings. 37.5% of the studies had sample sizes >200. Every sub region in SSA was represented. 87.5% of the studies covered the feasibility and effectiveness of surveillance programs with 1 study being a pilot for an ultrasound based surveillance system. 62.5% reported abdominal ultrasound and alpha-fetoprotein testing as the program of choice. 1 study showed adherence declining after 24 months to 77%. Barriers reported included inadequate infrastructure, out-of-pocket spending, and shortage of trained personnel. Studies recommended increased infrastructural investment, capacity-building initiatives, and community engagement to improve effectiveness. Conclusion: HCC surveillance programs in SSA are hindered by systemic challenges, resulting in delayed diagnosis and poor survival outcomes. More studies including rural areas will provide insights into specific needs, fostering equitable access to care. Urgent efforts addressing infrastructural gaps, enhancing training, health insurance coverage and integrating HCC surveillance into public health strategies are required to scale up structured programs and address the multifaceted barriers impeding their implementation. Citation Format: Sophia Okeke, Oluwadabira Adewara, David Akoki, Ifeanyichukwu Ijezie, Miracle Abraham, David Irabor, Fiyinfolu Balogun. Toward Early Detection: A Scoping Review of Hepatocellular Cancer Surveillance in Sub-Saharan Africa [abstract]. In: Proceedings of the 13th Annual Symposium on Global Cancer Research; 2025 Sep 16. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(12_Suppl):Abstract nr 29.