[A prospective study of early detection for primary liver cancer]

In order to evaluate the effectiveness of early detection for primary liver cancer (PLC), a randomized, prospective study was performed in Shanghai from 1992 to 1995. The study population was 35 through 55 years of age, with serum evidence of HBV infection or tory of chronic hepatitis. Seventeen thousand nine hundred and twenty individuals were randomly to allocated screening group and control group. In the screening group, every individual was checked up by serum AFP test and ultrasound every 6 months and in the control group, they were unchecked. After a mean time of 1.2 years, 38 patients with PLC in the screening group were detected while 18 patients with PLC occur in the control group. In patients from the screening group, 76.8% were in subclinical stage, 70.6% of them were treated by surgical resection with 1-, 2-year survival rate of 88.1% and 77.5%, respectively. However, in the control group, none of patients was in subclinical stage, none of the tumors resected, and none of patients survived over 1 year. The lead time was estimated to be 0.45 years. The cost for detecting an early stage PLC patient is RMB 12,600 (US$1,500). The study indicates that screening in the high risk population of PLC can detect patients in early stage, increase the resection rate and the survival rate. Screening program for PLC carried out in high risk populations is thus recommended.