Hepatocellular carcinoma screening: Difference between revisions

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{{Hepatocellular carcinoma}}
{{Hepatocellular carcinoma}}
 
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==Overview==
==Overview==
 
According to the American Association of Liver Diseases, [[Screening (medicine)|screening]] for hepatocellular carcinoma by [[ultrasound]] (US) is recommended among patients with [[hepatitis B]], [[hepatitis C]], and [[cirrhosis]]. [[Screening (medicine)|Screening]] is also recommended for Asian men over the age of 40, Asian women over the age of 50, and African American.  
"Surveillance is deemed cost-effective if the expected HCC risk exceeds 1.5% per year in patients with hepatitis C and 0.2% per year in patients with hepatitis B. Analysis of recent studies show that alpha-fetoprotein determination lacks adequate sensitivity and specificity for effective surveillance (and for diagnosis). Thus, surveillance has to be based on ultrasound examination. The recommended screening interval is 6 months" according to a [[clinical practice guideline]] by the [http://www.aasld.org/ American Association for the Study of Liver Diseases]. <ref name="pmid21374666"/>
==Screening==
 
[[Screening (medicine)|Screening]] for hepatocellular carcinoma by [[abdominal]] [[ultrasound]] and [[serum]] levels of [[alpha-fetoprotein]] is recommended for the following populations:<ref name="TradBibani2017">{{cite journal|last1=Trad|first1=Dorra|last2=Bibani|first2=Norsaf|last3=Sabbah|first3=Meriam|last4=Elloumi|first4=Hela|last5=Gargouri|first5=Dalila|last6=Ouakaa|first6=Asma|last7=Kharrat|first7=Jamel|title=Known, new and emerging risk factors of hepatocellular carcinoma (review)|journal=La Presse Médicale|volume=46|issue=11|year=2017|pages=1000–1007|issn=07554982|doi=10.1016/j.lpm.2017.09.025}}</ref><ref name="pmid29318354">{{cite journal |vauthors=Sirlin CB, Kielar AZ, Tang A, Bashir MR |title=LI-RADS: a glimpse into the future |journal=Abdom Radiol (NY) |volume=43 |issue=1 |pages=231–236 |year=2018 |pmid=29318354 |doi=10.1007/s00261-017-1448-1 |url=}}</ref>
"In a mixed-aetiology cohort, the most effective surveillance strategy is to screen each patient with AFP assay and ultrasound imaging on a 6-monthly basis" according to a [[systematic review]] by the [http://www.hta.ac.uk/ NIHR Health Technology Assessment programme] (UK). <ref name="pmid17767898"/>
*Patients with [[hepatitis B]]
 
*Patients with [[hepatitis C]]
==Evidence from trials==
*Patietns with [[cirrhosis]]
Regarding patients with [[hepatitis B]], a [[meta-analysis]] by the [[Cochrane Collaboration]] concluded "".<ref name="pmid22972059">{{cite journal| author=Aghoram R, Cai P, Dickinson JA| title=Alpha-foetoprotein and/or liver ultrasonography for screening of hepatocellular carcinoma in patients with chronic hepatitis B. | journal=Cochrane Database Syst Rev | year= 2012 | volume= 9 | issue= | pages= CD002799 | pmid=22972059 | doi=10.1002/14651858.CD002799.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22972059  }} </ref> In a [[randomized controlled trial]] included in the meta-analysis, the [[relative risk ratio]] of biannual [[alpha-fetoprotein]] and [[ultrasonography]], as compared to [[no screening]], for mortality from hepatocellular carcinoma was 0.6 and the [[relative risk reduction]] was 36.7%. In populations similar to those in this study which had a rate of risk as measured by the mortality from hepatocellular carcinoma of 0.13% without treatment, the [[number needed to treat]] is 2070. <ref name="pmid15042359"/>
*Asian men over the age of 40
 
*Asian women over the age of 50
*African American


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 22:08, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]

Overview

According to the American Association of Liver Diseases, screening for hepatocellular carcinoma by ultrasound (US) is recommended among patients with hepatitis B, hepatitis C, and cirrhosis. Screening is also recommended for Asian men over the age of 40, Asian women over the age of 50, and African American.

Screening

Screening for hepatocellular carcinoma by abdominal ultrasound and serum levels of alpha-fetoprotein is recommended for the following populations:[1][2]

References

  1. Trad, Dorra; Bibani, Norsaf; Sabbah, Meriam; Elloumi, Hela; Gargouri, Dalila; Ouakaa, Asma; Kharrat, Jamel (2017). "Known, new and emerging risk factors of hepatocellular carcinoma (review)". La Presse Médicale. 46 (11): 1000–1007. doi:10.1016/j.lpm.2017.09.025. ISSN 0755-4982.
  2. Sirlin CB, Kielar AZ, Tang A, Bashir MR (2018). "LI-RADS: a glimpse into the future". Abdom Radiol (NY). 43 (1): 231–236. doi:10.1007/s00261-017-1448-1. PMID 29318354.


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