Improving Health Care for Patients with Hepatocellular Carcinoma in the Federation of Bosnia and Herzegovina

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 five oncology centers in the Federation 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 significantly 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, especially, lack of screening programs. Implementation of targeted screening methods, regular monitoring of high-risk patients and enhanced use of biomarkers could lead to a significant improvement in the diagnostic accuracy. The limited use of innovative treatments recommended by the global guidelines was also identified 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.