(HealthDay)—For patients with chronic liver disease, hepatocellular carcinoma (HCC) screening can identify patients at an earlier stage, but the benefits and harms of screening are unclear, according to a study published online June 16 in the Annals of Internal Medicine.
Devan Kansagara, M.D., from the Portland Veterans Affairs Medical Center in Oregon, and colleagues conducted a systematic literature review to examine the benefits and harms of routine screening for HCC in patients with chronic liver disease. Twenty-two studies met the inclusion criteria.
The researchers found that evidence of the effects of screening was very low strength. Based on one large trial, periodic ultrasonographic screening correlated with decreased HCC mortality (rate ratio, 0.63), but methodological flaws limited the study. No survival benefit was seen with periodic α-fetoprotein screening in a trial involving patients with hepatitis B. Based on 18 observational studies, patients that underwent screening had earlier-stage HCC than patients who were diagnosed clinically, but the effects were confounded by lead- and length-time. No survival differences were found for shorter (three- to four-month) and longer (six- to 12-month) screening intervals, based on two trials. Screening harms were poorly studied.
"Screening tests can identify early-stage HCC, but whether systematic screening leads to a survival advantage over clinical diagnosis is uncertain," the authors write.
Explore further: Screening for liver cancer in patients with cirrhosis
More information: Abstract
Full Text
Editorial
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(HealthDay)—For patients with chronic liver disease, hepatocellular carcinoma (HCC) screening can identify patients at an earlier stage, but the benefits and harms of screening are unclear, according to a study published online June 16 in the Annals of Internal Medicine.
Devan Kansagara, M.D., from the Portland Veterans Affairs Medical Center in Oregon, and colleagues conducted a systematic literature review to examine the benefits and harms of routine screening for HCC in patients with chronic liver disease. Twenty-two studies met the inclusion criteria.
The researchers found that evidence of the effects of screening was very low strength. Based on one large trial, periodic ultrasonographic screening correlated with decreased HCC mortality (rate ratio, 0.63), but methodological flaws limited the study. No survival benefit was seen with periodic α-fetoprotein screening in a trial involving patients with hepatitis B. Based on 18 observational studies, patients that underwent screening had earlier-stage HCC than patients who were diagnosed clinically, but the effects were confounded by lead- and length-time. No survival differences were found for shorter (three- to four-month) and longer (six- to 12-month) screening intervals, based on two trials. Screening harms were poorly studied.
"Screening tests can identify early-stage HCC, but whether systematic screening leads to a survival advantage over clinical diagnosis is uncertain," the authors write.
Explore further: Screening for liver cancer in patients with cirrhosis
More information: Abstract
Full Text
Editorial
Copyright © 2014 HealthDay. All rights reserved.
Medical Xpress on facebook
Related Stories
Screening for liver cancer in patients with cirrhosis
Apr 01, 2014
In a systematic review and meta-analysis of 47 studies with 15,158 patients, Amit Singal (University of Texas Southwestern Medical Center) and colleagues found that patients with cirrhosis who underwent surveillance (via ...
Liver cancer screening highly beneficial for people with cirrhosis
May 05, 2014
Liver cancer survival rates could be improved if more people with cirrhosis are screened for tumors using inexpensive ultrasound scans and blood tests, according to a review by doctors at UT Southwestern ...
USPSTF: Evidence lacking for primary care suicide screening
May 20, 2014
(HealthDay)—The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to evaluate the balance of benefits and harms of suicide screening in the primary care ...
Patient factors affect accuracy of AFP detection of liver cancer
May 04, 2014
(HealthDay)—Measurement of α-fetoprotein (AFP) detects hepatocellular carcinoma (HCC) most accurately in patients without hepatitis C virus (HCV) infection, according to a study published in the May issue ...
Studies of patients with cirrhosis uncover limitations in liver cancer screening
Dec 01, 2011
Two studies available in the December issue of Hepatology, a journal of the American Association for the Study of Liver Diseases, have uncovered limitations in screening for primary liver cancer, also known as hepatocellular carcin ...
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Doctors at the University of Arizona Cancer Center at St. Joseph's Hospital and Medical Center in Phoenix reported today in Lancet Oncology that a new treatment for ovarian cancer can improve response rates (increase the ra ...
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© Medical Xpress 2011-2014, Science X network
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