Factors Associated with Hepatocellular Carcinoma at Gabriel Touré University Hospital, Bamako, Mali

Abstract

Introduction: Hepatocellular carcinoma (HCC) is a major public health problem in developing countries, particularly in sub-Saharan Africa. Objective: To evaluate the factors associated with hepatocellular carcinoma (HCC) in patients admitted to the hepatogastroenterology department of the Gabriel Touré University Hospital. Study Setting and Methods: This was a prospective, observational, case-control study of incident and control HCC cases between February 2024 and January 2025. We conducted a 1:1 matched case-control study (matched by sex and age) involving 218 patients, comprising 109 HCC cases and 109 controls. Results: Our study found a prevalence of 11.8%, with a male-to-female ratio of 5:1. The mean age was 48 years. A significant association was found with HBV infection (OR = 24.17; p = 0.01), alcohol and tobacco use (OR = 4.06; p = 0.02), tobacco use alone (OR = 2.23; p = 0.05), and the use of traditional medicines (OR = 3.27; p = 0.001). The majority of cases were diagnosed at an advanced stage (85.32% were classified as BCLC D), indicating a poor prognosis. Conclusion: Hepatocellular carcinoma is common in our region. Its diagnosis is most often delayed, and its prognosis therefore remains poor. This study highlights the need for early screening and a targeted prevention strategy that takes into account local specificities.