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.