Screening for hepatocellular cancer in chronic liver disease a systematic review

Several professional society guidelines currently recommend HCC screening using imaging studies and tumor markers mainly in patients with chronic hepatitis B or liver cirrhosis. However, recommendations for HCC screening remain controversial in part because of concerns over the quality and paucity o...

Full description

Bibliographic Details
Main Author: Kansagara, Devan
Corporate Authors: United States Department of Veterans Affairs, Portland VA Medical Center Evidence-based Synthesis Program Center, Quality Enhancement Research Initiative (U.S.)
Other Authors: Jou, Janice H.
Format: eBook
Language:English
Published: Washington, DC Department of Veterans Affairs, Health Services Research and Development Service 2014, January 2014
Series:Evidence-based synthesis program
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
LEADER 03593nam a2200349 u 4500
001 EB000944837
003 EBX01000000000000000738427
005 00000000000000.0
007 tu|||||||||||||||||||||
008 150223 r ||| eng
100 1 |a Kansagara, Devan 
245 0 0 |a Screening for hepatocellular cancer in chronic liver disease  |h Elektronische Ressource  |b a systematic review  |c principal investigators, Devan Kansagara, Janice H. Jou ; co-investigators, Joel Papak, Amirala S. Pasha, Maya O'Neil, Michele Freeman, Rose Relevo, Ana Quinones, Makalapua Motu'apuaka 
260 |a Washington, DC  |b Department of Veterans Affairs, Health Services Research and Development Service  |c 2014, January 2014 
300 |a 1 PDF file (iii, 61 pages)  |b illustrations 
505 0 |a Includes bibliographical references 
653 |a Liver Neoplasms / diagnosis 
653 |a Liver Cirrhosis / complications 
653 |a Early Detection of Cancer / methods 
653 |a Hepatitis, Chronic / complications 
700 1 |a Jou, Janice H. 
710 2 |a United States  |b Department of Veterans Affairs 
710 2 |a Portland VA Medical Center  |b Evidence-based Synthesis Program Center 
710 2 |a Quality Enhancement Research Initiative (U.S.) 
041 0 7 |a eng  |2 ISO 639-2 
989 |b NCBI  |a National Center for Biotechnology Information 
490 0 |a Evidence-based synthesis program 
500 |a Title from PDF title page 
856 4 0 |u https://www.ncbi.nlm.nih.gov/books/NBK222184  |3 Volltext  |n NLM Bookshelf Books  |3 Volltext 
082 0 |a 610 
520 |a Several professional society guidelines currently recommend HCC screening using imaging studies and tumor markers mainly in patients with chronic hepatitis B or liver cirrhosis. However, recommendations for HCC screening remain controversial in part because of concerns over the quality and paucity of existing evidence, and because there have been concerns raised about overdiagnosis and patient harms in other cancer screening programs. We conducted a systematic review of the published literature to better understand the incremental benefits and harms of routine HCC screening in patients with chronic liver disease compared to clinical or incidental diagnosis. We looked for direct evidence of the health outcome effects of screening.  
520 |a We also looked for indirect evidence of the effects of screening by evaluating studies examining the health outcome benefits and harms of treating early-stage HCC which, because the intent and result of routine screening is detection of early-stage disease, is a proxy for screen-detected disease 
520 |a In the Veterans Health Administration (VHA), there has been a marked increase in the prevalence of cirrhosis from chronic hepatitis C infection with a corresponding increase in the number of hepatocellular cancer (HCC) diagnoses. From 1996 to 2006, the prevalence of cirrhosis among Veterans with chronic hepatitis C infection rose from 9 to 18.5%, and the prevalence of HCC rose from 0.07 to 1.3%. In the general population, the incidence of HCC rose between 1992 and 2005 from 3.1/100,000 to 5.1/100,000, with localized tumors accounting for most of the increase. While, on average, the 5-year survival of HCC is low (13 to 16.5%), the survival of early-stage disease has risen. The rationale for screening is that imaging tests such as ultrasound can identify patients with early stage HCC and there are several potentially curative treatment options for patients with early stage HCC including liver transplantation, radiofrequency ablation, and liver resection.