Hepatocellular Carcinoma Surveillance in a Cohort of Chronic Hepatitis C Virus-Infected Patients with Cirrhosis

Details

• Alternative Title:
  J Gastrointest Cancer
• Personal Author:
  Abara, Winston E. ; Spradling, P. ; Zhong, Y. ; Moorman, A. ; Teshale, E. H. ; Rupp, L. ; Gordon, S. C. ; Schmidt, M. ; Boscarino, J. A. ; Daida, Y. G. ; Holmberg, S. D.
• Corporate Authors:
  CHeCS Investigators
• Description:
  Background
  
  Six-monthly hepatocellular carcinoma (HCC) screening in cirrhotic patients has been recommended since 2011. HCC prognosis is associated with diagnosis at an early stage. We examined the prevalence and correlates of 6-monthly HCC surveillance in a cohort of HCV-infected cirrhotic patients.
  
  Methods
  
  Data were obtained from the medical records of patients receiving care from four hospitals between January 2011 and December 2016. Frequencies and logistic regression were conducted.
  
  Results
  
  Of 2,933 HCV-infected cirrhotic patients, most were ≥ 60 years old (68.5%), male (62.2%), White (65.8%), and had compensated cirrhosis (74.2%). The median follow-up period was 3.5 years. Among these patients, 10.9% were consistently screened 6 monthly and 21.4% were never screened. Patients with a longer history of cirrhosis (AOR = 0.86, 95% CI = 0.80–0.93) were less likely to be screened 6 monthly while decompensated cirrhotic patients (AOR = 1.39, 95% CI = 1.06–1.81) and cirrhotic patients between 18 and 44 years (AOR = 2.01, 95% CI = 1.07–3.74) were more likely to be screened 6 monthly compared to compensated cirrhotic patients and patients 60 years and older respectively. There were no significant differences by race, gender, or insurance type.
  
  Conclusion
  
  The prevalence of consistent HCC surveillance remains low despite formalized recommendations. One in five patients was never surveilled. Patients with a longer history of cirrhosis were less likely to be surveilled consistently despite their greater HCC risk. Improving providers’ knowledge about current HCC surveillance guidelines, educating patients about the benefits of consistent HCC surveillance, and systemic interventions like clinical reminders and standing HCC surveillance protocols can improve guideline-concordant surveillance in clinical practice.
  
  
• Subjects:
  Aged Carcinoma, Hepatocellular Cohort Studies Female Hepatitis C, Chronic Humans Liver Cirrhosis Liver Neoplasms Male Mass Screening Middle Aged Prognosis

  More +
• Keywords:
  Chronic HCV Infection Cirrhosis Hepatitis C Virus Hepatocellular Carcinoma Hepatocellular Carcinoma Surveillance
• Source:
  J Gastrointest Cancer. 51(2):461-468
• Pubmed ID:
  31124041
• Pubmed Central ID:
  PMC6874701
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  51
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:64c638839e6350bfdc1b9bbe7e53c79c69f69ead0e29218ac3c7a9dc94d1a8ad
• Download URL:
  https://stacks.cdc.gov/view/cdc/83125/cdc_83125_DS1.pdf
• File Type:
  [PDF - 86.21 KB ]