Patient-Perceived Risk of Hepatocellular Carcinoma and Net Benefit of Surveillance: A Multicenter Survey Study.
| Title: | Patient-Perceived Risk of Hepatocellular Carcinoma and Net Benefit of Surveillance: A Multicenter Survey Study. |
|---|---|
| Authors: | Singal AG; Department of Internal Medicine, UT Southwestern Medical Center and Parkland Health, Dallas, Texas, USA.; Yang JD; Department of Internal Medicine, Cedars Sinai, Los Angeles, California, USA.; Jalal PK; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.; Salgia R; Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA.; Mehta N; Department of Internal Medicine, UC San Francisco, San Francisco, California, USA.; Hoteit MA; Department of Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania , USA.; Kao K; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.; Daher D; Department of Internal Medicine, UT Southwestern Medical Center and Parkland Health, Dallas, Texas, USA.; El Dahan KS; Department of Internal Medicine, UT Southwestern Medical Center and Parkland Health, Dallas, Texas, USA.; Hernandez P; Department of Internal Medicine, Cedars Sinai, Los Angeles, California, USA.; Nayak A; Department of Internal Medicine, Baylor College of Medicine, Houston, Texas, USA.; Kim N; Department of Internal Medicine, Cedars Sinai, Los Angeles, California, USA.; Pham S; Department of Internal Medicine, UC San Francisco, San Francisco, California, USA.; Gamez J; Department of Internal Medicine, UC San Francisco, San Francisco, California, USA.; Troost JP; Michigan Institute for Clinical and Health Research, Michigan Medicine, Ann Arbor, Michigan, USA.; Parikh ND; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA. |
| Source: | The American journal of gastroenterology [Am J Gastroenterol] 2025 Apr 23; Vol. 120 (8), pp. 1800-1808. Date of Electronic Publication: 2025 Apr 23. |
| Publication Type: | Journal Article; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 0421030 Publication Model: 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*/diagnosis ; Carcinoma, Hepatocellular*/etiology ; Carcinoma, Hepatocellular*/psychology ; Liver Neoplasms*/diagnosis ; Liver Neoplasms*/etiology ; Liver Neoplasms*/psychology ; Liver Cirrhosis*/complications ; Health Knowledge, Attitudes, Practice* ; Early Detection of Cancer*; Humans ; Female ; Male ; Middle Aged ; United States ; Aged ; Adult ; Risk Assessment ; Surveys and Questionnaires ; Population Surveillance |
| Abstract: | Introduction: Hepatocellular carcinoma (HCC) surveillance is underused in clinical practice, and few contemporary data have assessed patients' perceptions of surveillance effectiveness and net benefit.; Methods: We conducted a survey study among adult patients with cirrhosis at 7 health systems in the United States. The survey was based on validated measures, when available, and assessed patient knowledge about HCC surveillance, attitudes regarding surveillance benefits and harms, perceived HCC risk, and trust in their doctors.; Results: Respondents (n = 665; median age 60; 46.5% female) were knowledgeable about HCC surveillance, with no significant differences across sociodemographic groups; however, approximately 1 in 5 patients had knowledge gaps about the need and benefit of surveillance. Over three fourths of patients believed that surveillance improves early HCC detection (80.3%) and survival (77.9%). While 74.0% of patients reported that doctors had discussed surveillance benefits, only 54.2% recalled a discussion about potential harms. Patients placed greater importance on surveillance benefits, but expressed harms should be measured when assessing the net benefit of surveillance programs. Based on a pictogram depicting current estimates for surveillance benefits and harms, 93.2% of patients chose to undergo surveillance, with no significant differences by race, perceived surveillance benefits, or fear of dying from HCC. Study limitations include response and nonresponse biases, which may result in an overestimation of reported surveillance benefits and patient acceptance.; Discussion: Most patients with cirrhosis followed at academic health systems have high knowledge about HCC surveillance, believe that it is beneficial, and express interest in undergoing surveillance after being counseled about the benefits and harms.; (Copyright © 2025 by The American College of Gastroenterology.) |
| References: | Sci Adv. 2021 Dec 17;7(51):eabj2836. (PMID: 34919437); Hepatology. 2011 Dec;54(6):1998-2004. (PMID: 21800340); J Hepatol. 2023 Jul;79(1):226-239. (PMID: 36854345); J Natl Cancer Inst. 2025 Feb 01;117(2):262-269. (PMID: 39288308); Clin Gastroenterol Hepatol. 2022 Jan;20(1):183-193. (PMID: 32927050); Hepatology. 2023 Dec 1;78(6):1922-1965. (PMID: 37199193); EClinicalMedicine. 2024 Aug 13;75:102755. (PMID: 39234558); Soc Sci Med. 1992 May;34(10):1129-34. (PMID: 1641674); Ann Intern Med. 2022 Nov;175(11):1582-1590. (PMID: 36162112); Hepatology. 2017 Jul;66(1):292. (PMID: 28195334); J Hepatol. 2022 Jul;77(1):128-139. (PMID: 35139400); Hepatology. 2022 Mar;75(3):740-753. (PMID: 34923659); Hepatology. 2023 Mar 1;77(3):997-1005. (PMID: 35229329); Clin Gastroenterol Hepatol. 2024 Apr;22(4):760-767.e1. (PMID: 37544418); Liver Transpl. 2022 Dec;28(12):1865-1875. (PMID: 35980600); Clin Gastroenterol Hepatol. 2025 Feb;23(2):281-290.e4. (PMID: 39089513); Clin Gastroenterol Hepatol. 2023 Apr;21(4):1094-1096.e2. (PMID: 34965448); Eur J Gastroenterol Hepatol. 2015 Sep;27(9):1103-8. (PMID: 26049705); Hepatol Commun. 2023 Mar 7;7(3):. (PMID: 36881615); Hepatol Commun. 2022 May;6(5):1186-1197. (PMID: 34796703); Liver Transpl. 2019 Mar;25(3):369-379. (PMID: 30582779); Gastroenterology. 2018 Oct;155(4):1128-1139.e6. (PMID: 29981779); J Hepatol. 2022 Dec;77(6):1598-1606. (PMID: 36208844); Gut. 2024 Nov 11;73(12):2037-2044. (PMID: 38839269); Clin Gastroenterol Hepatol. 2023 Dec;21(13):3296-3304.e3. (PMID: 37390101); Ann Intern Med. 2024 Oct;177(10):1297-1307. (PMID: 39222505); J Hepatol. 2022 Mar;76(3):681-693. (PMID: 34801630); Med. 2021 Jul 09;2(7):836-850.e10. (PMID: 34318286); Clin Gastroenterol Hepatol. 2023 Jul;21(8):2135-2149. (PMID: 36813012); Gastroenterology. 2018 May;154(6):1706-1718.e1. (PMID: 29425931); J Hepatol. 2018 Jul;69(1):182-236. (PMID: 29628281); Nat Rev Clin Oncol. 2023 Dec;20(12):864-884. (PMID: 37884736); J Health Psychol. 2020 Mar;25(4):558-569. (PMID: 28795603); Hepatology. 2024 Jan 1;79(1):107-117. (PMID: 37401857); Am J Med. 2015 Jan;128(1):90.e1-7. (PMID: 25116425); Clin Gastroenterol Hepatol. 2022 Jul;20(7):1561-1569.e4. (PMID: 34119640); Hepatology. 2021 Feb;73(2):713-725. (PMID: 32383272); Clin Gastroenterol Hepatol. 2021 May;19(5):987-995.e1. (PMID: 32629122); Clin Gastroenterol Hepatol. 2019 Mar;17(4):766-773. (PMID: 30056183); Clin Gastroenterol Hepatol. 2015 Jan;13(1):172-9. (PMID: 24813175); J Clin Gastroenterol. 2011 Sep;45(8):727-32. (PMID: 21602704); Hepatology. 2017 Apr;65(4):1196-1205. (PMID: 27775821); BMJ. 2013 Sep 16;347:f5334. (PMID: 24041703); Nat Rev Gastroenterol Hepatol. 2023 Dec;20(12):797-809. (PMID: 37537332) |
| Grant Information: | R01 CA212008 United States CA NCI NIH HHS; U01 CA283935 United States CA NCI NIH HHS; RP200554 Cancer Prevention and Research Institute of Texas; R01 CA255621 United States CA NCI NIH HHS; R01 CA233794 United States CA NCI NIH HHS; R01 CA256977 United States CA NCI NIH HHS; R01 CA282178 United States CA NCI NIH HHS; U01 CA271887 United States CA NCI NIH HHS |
| Contributed Indexing: | Keywords: early detection; knowledge; liver cancer; screening; survey |
| Entry Date(s): | Date Created: 20250423 Date Completed: 20250801 Latest Revision: 20260424 |
| Update Code: | 20260424 |
| PubMed Central ID: | PMC12316564 |
| DOI: | 10.14309/ajg.0000000000003494 |
| PMID: | 40267274 |
| Database: | MEDLINE |
Journal Article; Multicenter Study