Few Patients With Hep C Cirrhosis Receive HCC Screening

Adherence to surveillance for hepatocellular carcinoma (HCC) in patients with chronic hepatitis C cirrhosis remains poor, according to new study findings.

For their study, the researchers evaluated 2366 patients with chronic hepatitis C cirrhosis at a single center between January 2001 and August 2015. All patients included in the present analysis were evaluated for at least 1 year.
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Findings revealed that adherence rates were 24.4% and 44% for 6-month imaging criteria set forth by the European Association for the Study of the Liver in 2000 and for 12-month imaging criteria issued by the American Association for the Study of Liver Diseases in 2005, respectively. The researchers observed no significant changes in adherence rates before and after 2011.

In this cohort, 9.6% of patients received a diagnosis of HCC. The researchers noted that patients who had adhered well to HCC surveillance recommendations were more likely to have smaller tumors (2.3 cm vs 3.3 cm), meet Milan criteria for liver transplants (73.2% vs 54.8%), and receive curative HCC treatment (43.6% vs 24.0%) compared with those with poor adherence.

According to multivariable analysis findings, curative treatment (hazard ratio [HR] 0.32) and undergoing imaging every 6 months (HR 0.34), but not ever 6 to 12 months, were associated with a lower risk of mortality.

Predictors of HCC surveillance adherence included being older than age 54 years (odds ratio [OR] 1.74), Asian ethnicity (OR 2.23), liver decompensation (OR 2.40), and having at least 2 clinical visits per year (OR 1.33).

“Adherence to HCC surveillance continues to be poor,” the researchers concluded. “Adherent patients with HCC were more likely to undergo curative treatment and have better survival.

“Research understanding barriers to surveillance is needed,” they added.

—Christina Vogt

Reference:

Tran SA, Le A, Zhao C, et al. Rate of hepatocellular carcinoma surveillance remains low for a large, real-life cohort of patients with hepatitis C cirrhosis. BMJ Open Gastroentrol. 2018;5(1). 10.1136/bmjgast-2017-000192

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