Only one-third of hepatocellular carcinoma cases are diagnosed via screening or surveillance: a systematic review and meta-analysis.
Journal
European journal of gastroenterology & hepatology
ISSN: 1473-5687
Titre abrégé: Eur J Gastroenterol Hepatol
Pays: England
ID NLM: 9000874
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
pubmed:
7
9
2019
medline:
29
7
2021
entrez:
7
9
2019
Statut:
ppublish
Résumé
Early hepatocellular carcinoma diagnosis is associated with better long-term survival. Studies of at-risk patients who are monitored in routine practice have reported an overall adherence rate to hepatocellular carcinoma screening/surveillance of approximately 60% and suboptimal diagnostic efficacy of the current screening/surveillance tools. However, it is unclear how many hepatocellular carcinoma patients were actually diagnosed via screening/surveillance given these obstacles. Therefore, via a systematic review of PubMed and Scopus databases from 2000 to 2019, we aimed to identify the proportion of patients with hepatocellular carcinoma diagnosed via screening/surveillance in routine practice. We included original research articles of studies of patients already diagnosed with hepatocellular carcinoma that reported the proportion of hepatocellular carcinoma diagnosed via screening/surveillance. The study included 60 studies and 50 554 hepatocellular carcinoma cases. The pooled proportion of hepatocellular carcinoma diagnosed by screening/surveillance was 37% (95% confidence interval: 31%-44%) and differed by geographic region (North America/Asia/Europe/Oceania/Africa/South America, 31%/42%/41%/30%/29%/47%, P = 0.017, respectively) and by surveillance interval (<12 months 39% vs. 12 months 19%, P < 0.01) but not by disease etiology, cirrhosis status, clinical setting, practice setting, hepatocellular carcinoma diagnosis period, or surveillance method. Globally, hepatocellular carcinoma was diagnosed via screening/surveillance in less than half of the patients (37%) regardless of healthcare setting or liver disease etiology and without improvement over time despite several recent guideline updates. Research is needed to understand the barriers to screening/surveillance to include medical as well as social and cultural influences.
Sections du résumé
BACKGROUND/OBJECTS
Early hepatocellular carcinoma diagnosis is associated with better long-term survival. Studies of at-risk patients who are monitored in routine practice have reported an overall adherence rate to hepatocellular carcinoma screening/surveillance of approximately 60% and suboptimal diagnostic efficacy of the current screening/surveillance tools. However, it is unclear how many hepatocellular carcinoma patients were actually diagnosed via screening/surveillance given these obstacles. Therefore, via a systematic review of PubMed and Scopus databases from 2000 to 2019, we aimed to identify the proportion of patients with hepatocellular carcinoma diagnosed via screening/surveillance in routine practice.
METHODS
We included original research articles of studies of patients already diagnosed with hepatocellular carcinoma that reported the proportion of hepatocellular carcinoma diagnosed via screening/surveillance.
RESULTS
The study included 60 studies and 50 554 hepatocellular carcinoma cases. The pooled proportion of hepatocellular carcinoma diagnosed by screening/surveillance was 37% (95% confidence interval: 31%-44%) and differed by geographic region (North America/Asia/Europe/Oceania/Africa/South America, 31%/42%/41%/30%/29%/47%, P = 0.017, respectively) and by surveillance interval (<12 months 39% vs. 12 months 19%, P < 0.01) but not by disease etiology, cirrhosis status, clinical setting, practice setting, hepatocellular carcinoma diagnosis period, or surveillance method.
CONCLUSION
Globally, hepatocellular carcinoma was diagnosed via screening/surveillance in less than half of the patients (37%) regardless of healthcare setting or liver disease etiology and without improvement over time despite several recent guideline updates. Research is needed to understand the barriers to screening/surveillance to include medical as well as social and cultural influences.
Identifiants
pubmed: 31490419
doi: 10.1097/MEG.0000000000001523
pii: 00042737-202003000-00018
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
406-419Références
El-Serag HB. Epidemiology of viral hepatitis and hepatocellular carcinoma. Gastroenterology. 2012; 142:1264.e1–1273.e1
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136:E359–E386
Singal AG, Pillai A, Tiro J. Early detection, curative treatment, and survival rates for hepatocellular carcinoma surveillance in patients with cirrhosis: a meta-analysis. Plos Med. 2014; 11:e1001624
Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018; 68:723–750
European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018; 69:182–236
Omata M, Cheng AL, Kokudo N, Kudo M, Lee JM, Jia J, et al. Asia-pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int. 2017; 11:317–370
Zhao C, Jin M, Le RH, Le MH, Chen VL, Jin M, et al. Poor adherence to hepatocellular carcinoma surveillance: asystematic review and meta-analysis of a complex issue. Liver Int. 2018; 38:503–514
Davila JA, Henderson L, Kramer JR, Kanwal F, Richardson PA, Duan Z, El-Serag HB. Utilization of surveillance for hepatocellular carcinoma among hepatitis C virus-infected veterans in the United States. Ann Intern Med. 2011; 154:85–93
Wu G, Wu J, Wang B, Zhu X, Shi X, Ding Y. Importance of tumor size at diagnosis as a prognostic factor for hepatocellular carcinoma survival: a population-based study. Cancer Manag Res. 2018; 10:4401–4410
Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL Conference. J Hepatol. 2001; 35:421–430
Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology. 2011; 53:1020–1022
Modesti PA, Reboldi G, Cappuccio FP, Agyemang C, Remuzzi G, Rapi S, et al.; ESH Working Group on CV Risk in Low Resource Settings. Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. Plos One. 2016; 11:e0147601
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21:1539–1558
Choi DT, Kum HC, Park S, Ohsfeldt RL, Shen Y, Parikh ND, Singal AG. Hepatocellular carcinoma screening is associated with increased survival of patients with cirrhosis. Clin Gastroenterol Hepatol. 2019; 17:976.e4–987.e4
Ashhab AA, Rodin H, Powell J, Debes JD. Impact of immigration in presentation and outcomes of hepatocellular carcinoma in the USA. Eur J Gastroenterol Hepatol. 2019; 31:24–28
Aby E, Phan J, Truong E, Grotts J, Saab S. Inadequate hepatocellular carcinoma screening in patients with nonalcoholic steatohepatitis cirrhosis. J Clin Gastroenterol. 2019; 53:142–146
Skladany L, Adamcova-Selcanova S, Malec V, Badinkova J, Pritzova E, Janek J, Okapec S. Hepatocellular carcinoma in central Slovakia: tertiary referral centre experience with 207 patients. Gastroenterol Hepatol. 2018; 72:99–107
Mules T, Gane E, Lithgow O, Bartlett A, McCall J. Hepatitis B virus-related hepatocellular carcinoma presenting at an advanced stage: is it preventable? N Z Med J. 2018; 131:27–35
Moon AM, Weiss NS, Beste LA, Su F, Ho SB, Jin GY, et al. No association between screening for hepatocellular carcinoma and reduced cancer-related mortality in patients with cirrhosis. Gastroenterology. 2018; 155:1128.e6–1139.e6
Kim HY, Nam JY, Lee JH, Lee HA, Chang Y, Lee HY, et al. Intensity of surveillance for hepatocellular carcinoma determines survival in patients at risk in a hepatitis B-endemic area. Aliment Pharmacol Ther. 2018; 47:1490–1501
Huang Y, Wallace MC, Adams LA, MacQuillan G, Garas G, Ferguson J, et al. Rate of nonsurveillance and advanced hepatocellular carcinoma at diagnosis in chronic liver disease. J Clin Gastroenterol. 2018; 52:551–556
Debes JD, Chan AJ, Balderramo D, Kikuchi L, Gonzalez Ballerga E, Prieto JE, et al. Hepatocellular carcinoma in south america: evaluation of risk factors, demographics and therapy. Liver Int. 2018; 38:136–143
Costentin CE, Layese R, Bourcier V, Cagnot C, Marcellin P, Guyader D, et al. Compliance with hepatocellular carcinoma surveillance guidelines associated with increased lead-time adjusted survival of patients with compensated viral cirrhosis: a multi-center cohort study. PLoS One. 2018; 155:431.e410–442.e410
Wong LL, Reyes RJ, Kwee SA, Hernandez BY, Kalathil SC, Tsai NC. Pitfalls in surveillance for hepatocellular carcinoma: how successful is it in the real world? Clin Mol Hepatol. 2017; 23:239–248
Singal AG, Mittal S, Yerokun OA, Ahn C, Marrero JA, Yopp AC, et al. Hepatocellular carcinoma screening associated with early tumor detection and improved survival among patients with cirrhosis in the US. Am J Med. 2017; 130:1099.e1–1106.e1
Rodriguez de Lope C, Reig M, Matilla A, Ferrer MT, Duenas E, Minguez B, et al. Clinical characteristics of hepatocellular carcinoma in Spain. Comparison with the 2008–2009 period and analysis of the causes of diagnosis out of screening programs. Analysis of 686 cases in 73 centers. Med Clin. 2017; 149:61–71
Okano JI, Matsuki Y, Nagahara R, Yamane M, Okamoto T, Miyoshi KI, et al. Compliance and problems with the surveillance program for HCC diagnosis. Nihon Shokakibyo Gakkai Zasshi. 2017; 114:1255–1263
Nam JY, Lee JH, Kim HY, Kim JE, Lee DH, Chang Y, et al. Oral medications enhance adherence to surveillance for hepatocellular carcinoma and survival in chronic hepatitis B patients. Plos One. 2017; 12:e0166188
Johnson P, Berhane S, Kagebayashi C, Satomura S, Teng M, Fox R, et al. Impact of disease stage and aetiology on survival in hepatocellular carcinoma: implications for surveillance. Br J Cancer. 2017; 116:441–447
Chiang JK, Chih-Wen L, Kao YH. Effect of ultrasonography surveillance in patients with liver cancer: a population-based longitudinal study. BMJ Open. 2017; 7:e015936
Chaiteerakij R, Chattieng P, Choi J, Pinchareon N, Thanapirom K, Geratikornsupuk N. Surveillance for hepatocellular carcinoma reduces mortality: an inverse probability of treatment weighted analysis. Ann Hepatol. 2017; 16:421–429
Yeh JH, Hung CH, Wang JH, Kuo YH, Tai WC, Lu SN. Hepatocellular carcinoma detected by regular surveillance: does timely confirmation of diagnosis matter? Dig Liver Dis. 2016; 48:661–666
Song JJ, Lu WY, Zhao ZW, Fan XX, Tu JF, Ji JS. [Association between ultrasound screening frequency and mortality in patients with hepatocellular carcinoma]. Zhonghua Yi Xue Za Zhi. 2016; 96:3652–3655
Piscaglia F, Svegliati-Baroni G, Barchetti A, Pecorelli A, Marinelli S, Tiribelli C, Bellentani S; HCC-NAFLD Italian Study Group. Clinical patterns of hepatocellular carcinoma in nonalcoholic fatty liver disease: a multicenter prospective study. Hepatology. 2016; 63:827–838
Oeda S, Iwane S, Takasaki M, Furukawa NE, Otsuka T, Eguchi Y, Anzai K. Optimal follow-up of patients with viral hepatitis improves the detection of early-stage hepatocellular carcinoma and the prognosis of survival. Intern Med. 2016; 55:2749–2758
Chen VL, Le AK, Kim NG, Kim LH, Nguyen NH, Nguyen PP, et al. Effects of cirrhosis on short-term and long-term survival of patients with hepatitis B-related hepatocellular carcinoma. Clin Gastroenterol Hepatol. 2016; 14:887.e1–895.e1
Webb GJ, Wright KV, Harrod EC, Gorard DA, Collier JD, Evans AK. Surveillance for hepatocellular carcinoma in a mixed-aetiology UK cohort with cirrhosis: does α-fetoprotein still have a role? Clin Med (Lond). 2015; 15:139–144
van Meer S, de Man RA, Coenraad MJ, Sprengers D, van Nieuwkerk KM, Klümpen HJ, et al. Surveillance for hepatocellular carcinoma is associated with increased survival: results from a large cohort in the Netherlands. J Hepatol. 2015; 63:1156–1163
Thein HH, Campitelli MA, Yeung LT, Zaheen A, Yoshida EM, Earle CC. Improved survival in patients with viral hepatitis-induced hepatocellular carcinoma undergoing recommended abdominal ultrasound surveillance in ontario: a population-based retrospective cohort study. PLos One. 2015; 10:e0138907
Shindo K, Maekawa S, Komatsu N, Tatsumi A, Miura M, Sato M, et al. Semiannual imaging surveillance is associated with better survival in patients with non-B, non-C hepatocellular carcinoma. Mediators Inflamm. 2015; 2015:687484
Mittal S, Sada YH, El-Serag HB, Kanwal F, Duan Z, Temple S, et al. Temporal trends of nonalcoholic fatty liver disease-related hepatocellular carcinoma in the veteran affairs population. Clin Gastroenterol Hepatol. 2015; 13:594.e1–601.e1
Eltabbakh M, Zaghla H, Abdel-Razek W, Elshinnawy H, Ezzat S, Gomaa A, Waked I. Utility and cost-effectiveness of screening for hepatocellular carcinoma in a resource-limited setting. Med Oncol. 2015; 32:432
Singal AG, Marrero JA, Yopp A. Screening process failures for hepatocellular carcinoma. J Natl Compr Canc Netw. 2014; 12:375–382
Dyson J, Jaques B, Chattopadyhay D, Lochan R, Graham J, Das D, et al. Hepatocellular cancer: the impact of obesity, type 2 diabetes and a multidisciplinary team. J Hepatol. 2014; 60:110–117
Wong N, Haydon A, Kemp W, Wijeratne P, Roberts S. Improved survival trend of patients with hepatocellular carcinoma at an Australian Tertiary Hospital between 1995-2009. Intern Med J. 2013; 43:197–203
Fenoglio L, Serraino C, Castagna E, Cardellicchio A, Pomero F, Grosso M, Senore C. Epidemiology, clinical-treatment patterns and outcome in 256 hepatocellular carcinoma cases. World J Gastroenterol. 2013; 19:3207–3216
Chamberlain J, Sarfati D, Cunningham R, Koea J, Gurney J, Blakely T. Incidence and management of hepatocellular carcinoma among māori and non-māori new zealanders. Aust N Z J Public Health. 2013; 37:520–526
Cazzagon N, Trevisani F, Maddalo G, Giacomin A, Vanin V, Pozzan C, et al.; Italian Liver Cancer (ITA.LI.CA) Group. Rise and fall of HCV-related hepatocellular carcinoma in italy: a long-term survey from the ITA.LI.CA centres. Liver Int. 2013; 33:1420–1427
Butt AS, Hamid S, Wadalawala AA, Ghufran M, Javed AA, Farooq O, et al. Hepatocellular carcinoma in native South Asian Pakistani population; trends, clinico-pathological characteristics & differences in viral marker negative & viral-hepatocellular carcinoma. BMC Res Notes. 2013; 6:137
Wong LL, Hernandez B, Kwee S, Albright CL, Okimoto G, Tsai N. Healthcare disparities in Asians and Pacific Islanders with hepatocellular cancer. Am J Surg. 2012; 203:726–732
Tong MJ, Siripongsakun S, Stanford-Moore G, Hsu L, Chang PW, Blatt LM. Tumor factors associated with clinical outcomes in patients with hepatitis B virus infection and hepatocellular carcinoma. Gastroenterol Hepatol (N Y). 2012; 8:808–819
Miquel M, Sopeña J, Vergara M, Gil M, Casas M, Sánchez-Delgado J, et al. Factors related to survival in hepatocellular carcinoma in the geographic area of sabadell (Catalonia, Spain). Rev Esp Enferm Dig. 2012; 104:242–247
Yang JD, Harmsen WS, Slettedahl SW, Chaiteerakij R, Enders FT, Therneau TM, et al. Factors that affect risk for hepatocellular carcinoma and effects of surveillance. Clin Gastroenterol Hepatol. 2011; 9:617.e1–623.e1
Stroffolini T, Trevisani F, Pinzello G, Brunello F, Tommasini MA, Iavarone M, et al. Changing aetiological factors of hepatocellular carcinoma and their potential impact on the effectiveness of surveillance. Dig Liver Dis. 2011; 43:875–880
Varela M, Reig M, de la Mata M, Matilla A, Bustamante J, Pascual S, et al. [Treatment approach of hepatocellular carcinoma in spain. Analysis of 705 patients from 62 centers]. Med Clin (Barc). 2010; 134:569–576
Tong MJ, Chavalitdhamrong D, Lu DS, Raman SS, Gomes A, Duffy JP, et al. Survival in Asian Americans after treatments for hepatocellular carcinoma: a seven-year experience at UCLA. J Clin Gastroenterol. 2010; 44:e63–e70
Noda I, Kitamoto M, Nakahara H, Hayashi R, Okimoto T, Monzen Y, et al. Regular surveillance by imaging for early detection and better prognosis of hepatocellular carcinoma in patients infected with hepatitis C virus. J Gastroenterol. 2010; 45:105–112
Nakano M, Ando E, Kuromatsu R, Torimura T, Sumie S, Takata A, et al. Recent progress in the management of hepatocellular carcinoma detected during a surveillance program in Japan. Hepatol Res. 2010; 40:989–996
Kuo YH, Lu SN, Chen CL, Cheng YF, Lin CY, Hung CH, et al. Hepatocellular carcinoma surveillance and appropriate treatment options improve survival for patients with liver cirrhosis. Eur J Cancer. 2010; 46:744–751
Jou JH, Chen PH, Jazwinski A, Bouneva I, Smith AD, Muir AJ. Rates of surveillance and management of hepatocellular carcinoma in patients evaluated at a liver transplant center. Dig Dis Sci. 2010; 55:3591–3596
El-Zayadi AR, Badran HM, Shawky S, Emara S, El-Bareedy A, Sobhi M. Effect of surveillance for hepatocellular carcinoma on tumor staging and treatment decisions in Egyptian patients. Hepatol Int. 2010; 4:500–506
Davila JA, Morgan RO, Richardson PA, Du XL, McGlynn KA, El-Serag HB. Use of surveillance for hepatocellular carcinoma among patients with cirrhosis in the United States. Hepatology. 2010; 52:132–141
Akahoshi H, Taura N, Ichikawa T, Miyaaki H, Akiyama M, Miuma S, et al. Differences in prognostic factors according to viral status in patients with hepatocellular carcinoma. Oncol Rep. 2010; 23:1317–1323
Farinati F, Sergio A, Giacomin A, Di Nolfo MA, Del Poggio P, Benvegnù L, et al.; Italian Liver Cancer group. Is female sex a significant favorable prognostic factor in hepatocellular carcinoma? Eur J Gastroenterol Hepatol. 2009; 21:1212–1218
Wong GL, Wong VW, Tan GM, Ip KI, Lai WK, Li YW, et al. Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitis. Liver Int. 2008; 28:79–87
Pascual S, Irurzun J, Zapater P, Such J, Sempere L, Carnicer F, et al. Usefulness of surveillance programmes for early diagnosis of hepatocellular carcinoma in clinical practice. Liver Int. 2008; 28:682–689
Gellert L, Jalaludin B, Levy M. Hepatocellular carcinoma in Sydney South West: late symptomatic presentation and poor outcome for most. Intern Med J. 2007; 37:516–522
Davila JA, Weston A, Smalley W, El-Serag HB. Utilization of screening for hepatocellular carcinoma in the United States. J Clin Gastroenterol. 2007; 41:777–782
Tanaka H, Nouso K, Kobashi H, Kobayashi Y, Nakamura S, Miyake Y, et al. Surveillance of hepatocellular carcinoma in patients with hepatitis C virus infection may improve patient survival. Liver Int. 2006; 26:543–551
Cheung TK, Lai CL, Wong BC, Fung J, Yuen MF. Clinical features, biochemical parameters, and virological profiles of patients with hepatocellular carcinoma in Hong Kong. Aliment Pharmacol Ther. 2006; 24:573–583
Ando E, Kuromatsu R, Tanaka M, Takada A, Fukushima N, Sumie S, et al. Surveillance program for early detection of hepatocellular carcinoma in Japan: results of specialized department of liver disease. J Clin Gastroenterol. 2006; 40:942–948
Van Vlierberghe H, Colle I, Henrion J, Michielsen P, Delwaide J, Reynaert H, et al.; Belgian Assocation for the Study of the Liver steering committee. The Hepcar Registry: report on a one-year registration program of hepatocellular carcinoma (HCC) in belgium. What is daily practice in HCC? Acta Gastroenterol Belg. 2005; 68:403–411
Trevisani F, De Notariis S, Rapaccini G, Farinati F, Benvegnù L, Zoli M, et al.; Italian Liver Cancer Group. Semiannual and annual surveillance of cirrhotic patients for hepatocellular carcinoma: effects on cancer stage and patient survival (Italian experience). Am J Gastroenterol. 2002; 97:734–744
Omata M, Lesmana LA, Tateishi R, Chen PJ, Lin SM, Yoshida H, et al. Asian Pacific association for the study of the liver consensus recommendations on hepatocellular carcinoma. Hepatol Int. 2010; 4:439–474
Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology. 2005; 42:1208–1236
Zhao C, Nguyen MH. Hepatocellular carcinoma screening and surveillance: practice guidelines and real-life practice. J Clin Gastroenterol. 2016; 50:120–133
Tzartzeva K, Obi J, Rich NE, Parikh ND, Marrero JA, Yopp A, et al. Surveillance imaging and alpha fetoprotein for early detection of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis. Gastroenterology. 2018; 154:1706.e1–1718.e1
Kisiel JB, Dukek BA, V S R Kanipakam R, Ghoz HM, Yab TC, Berger CK, et al. Hepatocellular carcinoma detection by plasma methylated DNA: discovery, phase I pilot, and phase II clinical validation. Hepatology. 2019; 69:1180–1192
Borges KA, Dai J, Parikh ND, Schwartz M, Nguyen MH, Roberts LR, et al. Rationale and design of the hepatocellular carcinoma early detection strategy study: a multi-center longitudinal initiative of the National Cancer Institute’s Early Detection Research Network. Contemp Clin Trials. 2019; 76:49–54
Beste LA, Ioannou GN, Yang Y, Chang MF, Ross D, Dominitz JA. Improved surveillance for hepatocellular carcinoma with a primary care-oriented clinical reminder. Clin Gastroenterol Hepatol. 2015; 13:172–179
Svendsen MT, Andersen F, Andersen KH, Pottegård A, Johannessen H, Möller S, et al. A smartphone application supporting patients with psoriasis improves adherence to topical treatment: a randomized controlled trial. Br J Dermatol. 2018; 179:1062–1071
Graetz I, McKillop CN, Stepanski E, Vidal GA, Anderson JN, Schwartzberg LS. Use of a web-based app to improve breast cancer symptom management and adherence for aromatase inhibitors: a randomized controlled feasibility trial. J Cancer Surviv. 2018; 12:431–440
Singal AG, Tiro JA, Murphy CC, Marrero JA, McCallister K, Fullington H, et al. Mailed outreach invitations significantly improve HCC surveillance rates in patients with cirrhosis: a randomized clinical trial. Hepatology. 2019; 69:121–130