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Patient Preferences in Hepatocellular Carcinoma Surveillance: A Multisite Conjoint Analysis
Karissa D Kao1, Jonathan P Troost2, Ju Dong Yang3
1Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.
The American Journal of Gastroenterology
|April 14, 2026
Summary
Patient preferences for hepatocellular carcinoma (HCC) surveillance vary significantly by race, ethnicity, and socioeconomic status. Addressing financial and logistical barriers is key to improving HCC surveillance uptake and effectiveness.
Area of Science:
- Hepatocellular carcinoma (HCC) research
- Patient-centered care
- Health disparities
Background:
- Emerging surveillance modalities for hepatocellular carcinoma (HCC) exist.
- Patient preferences for these tests, especially across diverse racial/ethnic and socioeconomic groups, are not well understood.
Purpose of the Study:
- To characterize patient preferences for HCC surveillance tests.
- To identify how preferences vary among different racial/ethnic and socioeconomic subgroups.
Main Methods:
- A choice-based conjoint survey was administered to 649 patients with cirrhosis or chronic hepatitis B undergoing HCC surveillance.
- Participants evaluated 15 scenarios, choosing surveillance modalities based on attributes like benefits, harms, cost, and logistics.
Main Results:
- Surveillance benefits were the highest priority attribute (42.9%), followed by financial harms (19.4%).
- Black and Hispanic participants, and those with lower socioeconomic status, prioritized financial harms and test duration over surveillance benefits.
- Lower education, Medicaid insurance, and lower income were associated with greater importance placed on financial harms.
Conclusions:
- Hepatocellular carcinoma surveillance test sensitivity is prioritized, but preferences differ by race, ethnicity, and socioeconomic status.
- Shared decision-making that reduces financial and logistical barriers can enhance surveillance, particularly when test effectiveness is similar.
