Improving Health Care for Patients with Hepatocellular Carcinoma in the Federation of Bosnia and Herzegovina
Azra Rasic1, Emir Sokolovic1, Lejla Alidzanovic Nurkanovic2, Inga Marijanovic3, Alma Mekic-Abazovic4, Semir Beslija1
1 Clinic of Oncology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
2 Clinic of Oncology and Radiotherapy, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
3 Oncology Clinic, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
4 Department of Oncology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina
Corresponding Author: Emir Sokolovic MD. Clinic of Oncology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina; E-mail: emir.sokolovic.ldv@gmail.com; Phone: +387 61 507 537; ORCID ID: 0000-0001-7015-7378
Cite this article: Rasic A, Sokolovic E, Alidzanovic-Nurkanovic L, Marijanovic I, Mekic-Abazovic A, Beslija S. Improving Health Care for Patients with Hepatocellular Carcinoma in the Federation of Bosnia and Herzegovina. Sar Med J. 2024; 1(2): Online ahead of print. 
10.70119/0016-24
Pages: 110-113 / Published online: 16 December 2024
Original submission: 15 September 2024; Revised submission: 07 November 2024; Accepted: 27 November 2024
Abstract
Hepatocellular carcinoma (HCC) is the sixth most common cancer globally and the third leading cause of cancer-related deaths. It remains especially lethal among patients with cirrhosis and chronic liver diseases like hepatitis B and C, alcohol abuse and non-alcoholic fatty liver disease. A retrospective, multicenter study was conducted across fi ve oncology centers in the Federati-on of Bosnia and Herzegovina, with the aim of gaining a better insight into the current state of healthcare for patients with HCC in this region. The study reveals several regional disparities in the etiology, treatment, and outcomes of HCC, but it also indicates that the diagnostic approach varies signifi cantly from one city to another. One of the highlights of the study is the late-stage diagnosis of most patients, due to the limited healthcare access, diagnostic delays and, es-pecially, lack of screening programs. Implementation of targeted screening methods, regular monitoring of high-risk patients and enhanced use of biomarkers could lead to a signifi cant im-provement in the diagnostic accuracy. The limited use of innovative treatments recommended by the global guidelines was also identifi ed as an issue, which directly leads to limited surgical and other treatment options. This study signals the need for a standardized patient pathway in the Federation of Bosnia and Herzegovina, implementation of national registry and targeted HCC database, which could reduce mortality, improve overall care and patient outcomes.
Keywords: hepatocellular carcinoma, healthcare, standardized patient pathway.
