Benefits and harms of hepatocellular carcinoma screening outreach in patients with cirrhosis: a multicenter randomized clinical trial
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View abstract on PubMed
Summary
This summary is machine-generated.A mailed outreach strategy for hepatocellular carcinoma (HCC) screening in cirrhosis patients did not improve early tumor detection or increase harms compared to usual care. Most patients were diagnosed at an early stage, with few experiencing adverse effects.
Area Of Science
- Hepatology
- Oncology
- Public Health
Background
- The effectiveness of hepatocellular carcinoma (HCC) screening relies on balancing early detection benefits against harms from false positives.
- Evaluating novel outreach strategies is crucial for optimizing HCC screening in high-risk populations like patients with cirrhosis.
Purpose Of The Study
- To assess the value of a mailed outreach strategy for HCC screening in patients with cirrhosis.
- To compare early-stage HCC detection rates and screening-related harms between mailed outreach and usual care.
Main Methods
- A multicenter pragmatic randomized clinical trial compared mailed outreach HCC screening (n=1436) with usual care/visit-based screening (n=1436) in cirrhosis patients.
- Outcomes included early-stage HCC detection (benefit) and diagnostic evaluations for false-positive/indeterminate results (harm), categorized by severity.
- Intention-to-screen analyses were performed for all enrolled patients.
Main Results
- Early-stage HCC detection rates were similar between the outreach and usual care groups (64.2% vs. 79.3%; P=.06).
- The proportion of patients experiencing physical harms from screening did not differ significantly between the groups (10.8% vs. 10.7%; P=.95).
- Mild, moderate, and severe harms occurred at comparable rates in both arms.
Conclusions
- The majority of HCC cases identified through screening were at an early stage.
- A mailed outreach strategy for HCC screening did not enhance early tumor detection or increase physical harms compared to usual care in patients with cirrhosis.
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