Hepatocellular carcinoma in the United Arab Emirates

In the United Arab Emirates (UAE), the burden of hepatocellular carcinoma is low but rising gradually. While the total burden remains small (about 220 new cases annually), the incidence rate has risen from 1.1 cases per 100,000 population in 1990 to 2.37 cases per 100,000 in 2019. This rise is in parallel with increasing rates of obesity, diabetes, alcohol use, and other chronic diseases. However, the rate remains substantially lower than regional and global averages. In the UAE, about 53% of liver cancer cases are attributable to infection with hepatitis B virus, while 21% are due to hepatitis C virus. The role of nonalcoholic steatohepatitis (NASH) is also increasing but still contributes only 10%. Alcohol use is estimated to cause another 10% of liver cancer cases annually. Other causes of liver cancer have a relatively minor contribution. Incidence peaks at around 80 to 90 years, with new cases being diagnosed as early as 40. The male to female ratio is 2.7:1 in the UAE. In terms of risk factor control, hepatitis C prevalence is low (<0.1%), comparable to developed countries, while hepatitis B vaccination coverage is almost universal, being given at birth. Growing obesity and diabetes in the region is predicted to increase the burden of liver cancer. Thus, there is a need to develop public health strategies to reduce obesity and limit alcohol consumption.