This article is more than 5 years old. Information may no longer be current.
Benefit of HCC Screening Uncertain for Patients with Chronic Liver Disease
It remains uncertain whether systematic screening for hepatocellular carcinoma is associated with a survival advantage in patients with chronic liver disease, according to data from a systematic review published in Annals of Internal Medicine.
Although screening identifies patients with early-stage [hepatocellular carcinoma] and some patients do well with curative therapy, there is very low-strength evidence from which to draw conclusions about the balance of benefits and harms of screening for [hepatocellular carcinoma], researchers from Portland Veterans Affairs Medical Center and Oregon Health and Science University wrote.
The review focused on 22 relevant studies including trials and observational studies. In the two randomized controlled trials, researchers compared the effects on mortality of screening for hepatocellular carcinoma (HCC) vs. no screening. However, the researchers said both studies had significant limitations and risk for bias. Two additional trials compared different ultrasonography screening intervals and found no difference in HCC mortality.
In 18 observational studies, survival was compared between patients who had HCC detected by screening vs. patients who had HCC detected incidentally. Most of the studies included patients with hepatitis B virus or hepatitis C virus with cirrhosis. Although the general findings were that HCC was found at an earlier stage among those who were screened and survival was higher, the researchers cited methodological flaws of the studies as well as potential for bias.
There is very low-strength evidence about the effects of HCC screening on mortality in high-risk patients with chronic liver disease, the researchers concluded. There is limited evidence from which to draw firm conclusions about the balance of health outcome benefits and harms of using routine screening to identify HCC.