Proportion of Time Covered by Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis.
| Title: | Proportion of Time Covered by Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis. |
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| Authors: | Daher D; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Seif El Dahan K; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Yekkaluri S; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Gopal P; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Rich NE; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.; Parikh ND; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.; Murphy CC; School of Public Health, UT Health Science Center, Houston, Texas, USA.; Singal AG; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA. |
| Source: | The American journal of gastroenterology [Am J Gastroenterol] 2024 May 01; Vol. 119 (5), pp. 875-882. Date of Electronic Publication: 2023 Nov 17. |
| Publication Type: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 0421030 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1572-0241 (Electronic) Linking ISSN: 00029270 NLM ISO Abbreviation: Am J Gastroenterol Subsets: MEDLINE |
| Imprint Name(s): | Publication: : [Philadelphia, PA] : Wolters Kluwer Health; Original Publication: New York, Elsevier Science, -2003. |
| MeSH Terms: | Carcinoma, Hepatocellular*/epidemiology ; Carcinoma, Hepatocellular*/mortality ; Carcinoma, Hepatocellular*/diagnostic imaging ; Liver Neoplasms*/epidemiology ; Liver Neoplasms*/diagnostic imaging ; Liver Cirrhosis*/complications ; Liver Cirrhosis*/epidemiology ; Early Detection of Cancer*/methods; United States/epidemiology ; Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; Time Factors |
| Abstract: | Introduction: Hepatocellular carcinoma (HCC) surveillance is associated with improved early tumor detection, but effectiveness is limited by underuse. We characterized adherence to HCC surveillance using proportion of time covered (PTC) and estimated its association with clinical outcomes among patients with cirrhosis.; Methods: We conducted a retrospective cohort study of patients diagnosed with HCC between January 2008 and December 2022 at 2 large US health systems. We characterized PTC by imaging in the 12 and 24 months before HCC diagnosis. We used multivariable logistic and Cox regression analyses to assess the association between PTC and early HCC detection, receipt of curative treatment, and overall survival.; Results: Among 2,027 patients with HCC, 331 (51.4% Barcelona Clinic Liver Cancer 0/A) had been followed up for at least 12 months before diagnosis. The median PTC was 24.9% (interquartile range 1.1%-50.7%), with only 16.0% having semiannual imaging and 42.0% having annual surveillance. Semiannual and annual surveillance decreased to 6.3% and 29.6% when assessed over 24 months, although the median PTC remained unchanged at 24.9%. Receipt of gastroenterology/hepatology care had the strongest association with PTC, with median PTC of 36.7% and 3.8% for those with and without gastroenterology/hepatology care, respectively. PTC was independently associated with improved early HCC detection, curative treatment receipt, and overall survival. The median survival was 15.7, 26.8, and 32.7 months among those with PTC of 50% (n = 94 patients), respectively.; Discussion: The proportion of time covered by HCC surveillance in patients with cirrhosis remains low, highlighting a need for multilevel interventions.; (Copyright © 2023 by The American College of Gastroenterology.) |
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| Grant Information: | R01 CA212008 United States CA NCI NIH HHS; R01 CA222900 United States CA NCI NIH HHS; U01 CA230694 United States CA NCI NIH HHS; U01 DK130113 United States DK NIDDK NIH HHS |
| Entry Date(s): | Date Created: 20231117 Date Completed: 20240503 Latest Revision: 20250502 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11068493 |
| DOI: | 10.14309/ajg.0000000000002596 |
| PMID: | 37975606 |
| Database: | MEDLINE |
Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't