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Compliance and problems with the surveillance program for HCC diagnosis
Jun-Ichi Okano1,2, Yukako Matsuki1, Ran Nagahara1
1Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University School of Medicine.
Insights
Early hepatocellular carcinoma (HCC) diagnosis requires improved identification of hepatitis B virus (HBV) and hepatitis C virus (HCV) carriers, alongside understanding non-B non-C (NBNC) HCC risk factors.
Area of Science:
- Hepatology
- Oncology
- Public Health
Background:
- Primary hepatocellular carcinoma (HCC) remains a significant global health challenge.
- Understanding the diverse etiologies and diagnostic pathways for HCC is crucial for effective management.
- Hepatitis B virus (HBV), hepatitis C virus (HCV), and non-B non-C (NBNC) etiologies represent distinct patient populations with varying risk factors.
Purpose of the Study:
- To evaluate the background and diagnostic opportunities for patients with primary HCC.
- To identify the etiologies, patient characteristics, and diagnostic methods employed in HCC cases.
- To assess compliance with surveillance programs and identify barriers to early HCC detection.
Main Methods:
- A multicenter retrospective study was conducted.
- Data from 651 patients with primary HCC were analyzed.
- Etiologies, patient demographics, diagnostic imaging (ultrasonography, dynamic CT, conventional CT), and surveillance program compliance were reviewed.
Main Results:
- The study included 651 HCC patients with etiologies of HBV (20.0%), HCV (36.3%), and NBNC (43.5%).
- NBNC HCC patients often presented with fewer cirrhotic livers but higher rates of lifestyle-related diseases.
- Diagnostic compliance with surveillance programs was suboptimal, with key barriers including undiagnosed carriers and physician non-compliance.
Conclusions:
- Improving the diagnosis and follow-up of HBV and HCV carriers is essential for early HCC detection.
- Enhanced physician education and identification of NBNC HCC risk factors are critical.
- Addressing barriers in surveillance programs can significantly improve early diagnosis and patient outcomes.
Abstract:
We conducted a multicenter retrospective study for evaluating the background of and diagnostic opportunity for 651 patients with primary hepatocellular carcinoma (HCC). The etiologies were hepatitis B virus (HBV) in 20.0% of patients, hepatitis C virus (HCV) in 36.3%, and non-B non-C (NBNC) in 43.5%. The characteristics of non-alcoholic NBNC HCC patients included low frequency of liver cirrhosis and high frequency of life style-related diseases. The mean diameter of HCC was approximately 4cm. Most patients were diagnosed using ultrasonography and dynamic computed tomography (CT). However, 18.6% of patients were diagnosed using conventional contrast-enhanced CT. Compliance with the surveillance program for HCC diagnosis was 35.4% in HBV carriers and 49.2% in HCV carriers. The main causes of deviation from the program included undiagnosed HBV and HCV carriers, non-compliance with the surveillance program by physicians, and no medical care for HBV and HCV carriers. For an early diagnosis of HCC, it is essential to improve the diagnoses of HBV and HCV carriers, promote the follow-ups of HBV and HCV carriers in hospitals, re-educate physicians, and identify the risk factors of NBNC HCC.
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