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A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Meta-Analysis: Utilisation of Hepatocellular Carcinoma Surveillance
Nicole Shu Ying Tang1, Shyna Gunalan1, Christen En Ya Ong1
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Background And Aims:
Major society guidelines recommend hepatocellular carcinoma (HCC) surveillance every 6 months with hepatic ultrasound. HCC surveillance is associated with early detection and improved survival but is underutilised. We aim to provide an updated assessment of HCC surveillance utilisation.
Methods:
Ovid MEDLINE and Embase were searched from inception until 30 November 2023 to identify studies reporting the proportion of people with either cirrhosis or chronic hepatitis B who underwent ultrasound-based HCC surveillance. The primary objective was to determine the utilisation of HCC surveillance. A meta-analysis of proportions was conducted using a generalised linear mixed model.
Results:
Forty-eight articles (1,275,349 individuals) met inclusion criteria. In at-risk individuals (cirrhosis or chronic hepatitis B), pooled utilisation of any HCC surveillance (n = 21 studies) was 54.45% (95% CI: 37.77-70.19), and utilisation of biannual surveillance (n = 7 studies) was 8.76% (95% CI: 2.46-26.79). Utilisation of any HCC surveillance was 53.37% (95% CI: 33.72-72.03) in patients with cirrhosis (n = 15 studies) and 66.43% (95% CI: 42.74-83.99) in patients with chronic hepatitis B (n = 12 studies), while utilisation of biannual surveillance was 10.20% (95% CI: 1.92-39.71) and 12.96% (95% CI: 0.02-99.09) respectively. Utilisation of surveillance did not improve over time. Pooled analysis of 40,497 individuals diagnosed with HCC (n = 27 studies) determined that the proportion of patients who had undergone prior screening or been diagnosed by surveillance was 36.07% (95% CI: 28.30-44.63).
Conclusions:
Less than 10% of patients received the recommended biannual ultrasound scans for surveillance. These findings are concerning and call for greater awareness and collaboration between care providers and healthcare policymakers to improve surveillance utilisation.
