Rates and Predictors of Undergoing Different Hepatocellular Carcinoma Screening Tests in Patients With Cirrhosis

Am J Gastroenterol. 2021 Feb 1;116(2):411-415. doi: 10.14309/ajg.0000000000001000.

Abstract

Introduction: We aimed to assess rates and predictors of hepatocellular carcinoma (HCC) screening among patients with cirrhosis.

Methods: We reviewed electronic health records of 11,361 patients with cirrhosis from 11 U.S. Veterans Health Administration facilities for receipt of HCC screening in the 6 months preceding October 1, 2019.

Results: Nearly half of the cohort (46%) received HCC screening over a 6-month period. Screening rates and modalities (ultrasound, computed tomography, magnetic resonance imaging, serum alpha fetoprotein) varied by facility. Screening was associated with race/ethnicity, body mass index ≥ 25, cirrhosis etiology, thrombocytopenia, Fibrosis-4 ≥ 3.25, and lower Model for End-Stage Liver Disease-Sodium.

Discussion: HCC screening rates varied by facility. Higher risk patients were more likely to receive screening.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / metabolism
  • Aspartate Aminotransferases / metabolism
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / metabolism
  • Early Detection of Cancer / statistics & numerical data*
  • End Stage Liver Disease
  • Ethnicity / statistics & numerical data
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Hispanic or Latino
  • Humans
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / metabolism
  • Liver Cirrhosis / therapy*
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / metabolism
  • Magnetic Resonance Imaging / statistics & numerical data
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Overweight / epidemiology
  • Practice Guidelines as Topic
  • Severity of Illness Index
  • Thrombocytopenia / epidemiology
  • Tomography, X-Ray Computed / statistics & numerical data
  • Ultrasonography / statistics & numerical data
  • United States
  • United States Department of Veterans Affairs
  • alpha-Fetoproteins / metabolism

Substances

  • Biomarkers, Tumor
  • alpha-Fetoproteins
  • Aspartate Aminotransferases
  • Alanine Transaminase