Cost-effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosis

Sarasin, François; Giostra, Emiliano; Hadengue, Antoine

doi:10.1016/s0002-9343(96)00197-0

Cited by 322 publications

(199 citation statements)

References 51 publications

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“…In a third study of selected individuals with Child grade A cirrhosis, the cost per life per year gained was between $26,000 and $55,000. 70 This contrasts with $25,000 per life year saved by screening for colorectal cancer, which is considered to be costeffective. 71 Screening/surveillance for HCC has become accepted practice by hepatologists worldwide, particularly in patients with cirrhosis.…”

Section: Challenges To the Institution Of Effective Screening/surveilmentioning

confidence: 99%

Screening for hepatocellular carcinoma

1998

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Section: Challenges To the Institution Of Effective Screening/surveilmentioning

confidence: 99%

Screening for hepatocellular carcinoma

1998

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“…15,16 Most studies have not shown HCC screening to be cost-effective in the general cirrhotic population. 17,18 Nevertheless, patients at an increased risk for HCC are screened using blood tests (alphafetaprotein [AFP]), radiological studies (ultrasound [U/S], computed tomography [CT]), or a combination of both blood tests and radiological studies. Each screening method is associated with different costs and accuracies.…”

mentioning

confidence: 99%

Hepatocellular carcinoma screening in patients waiting for liver transplantation: A decision analytic model

Saab

Ly²,

Nieto

et al. 2003

Liver Transplantation

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“…36 A prospective cohort study from Italy which had done surveillance using AFP and USG at 6-month intervals found the cost to be US$112,993 per life-year saved. 37 Two systematic reviews have also looked at cost effective strategies for surveillance in HCC. The first Systematic review by Coon et al had surveillance of patients with cirrhosis (related to Alcoholic Liver Diseases, HBV, HCV infection), using AFP testing and/or liver ultrasound examination, to detect HCC, followed by treatment with liver transplantation or resection.…”

Section: Cost-effective and Feasible Strategy For Hepatocellular Carcmentioning

confidence: 99%

Role of Surveillance in Prevention of Hepatocellular Carcinoma

Panda

2014

Journal of Clinical and Experimental Hepatology

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Hepatocellular carcinoma is a common malignancy and one of the important public health problems in India. The surveillance of hepatocellular carcinoma (HCC) is an established approach to detect early cancers in patients with defined risks. However, there are still controversies and issues to be addressed regarding the optimal surveillance methods and interval. The current level of awareness among physicians in India about surveillance is low and the need and most cost effective surveillance strategy in developing country like ours is unclear. This article has tried to discuss these issues in their appropriate perspective. To address this complicated issue, a multicenter randomized prospective study however may be required. ( J CLIN EXP HEPATOL 2014;4:S43-S49) H epatocellular carcinoma (HCC) is the fifth commonest cancer worldwide and third commonest cause of cancer related mortality. 1 In India, the mean incidence of HCC as per four population-based registries was 2.77% for males and 1.38% for females. The prevalence of HCC in India varies from 0.2% to 1.6%. 2,3 It is interesting to note that the consolidated data from cancer registries of India do not reflect HCC as an important malignancy. 4 Risk of HCC development is high in patients with liver cirrhosis of any etiology, particularly with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. 5 Since India has a high prevalence of HBV infection (4% of population, i.e about 40 million Indians) 6 as well as HCV infection (0.3-1.5%) it could contribute to the high incidence of HCC. 7 Other risk factors for HCC like high prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) obesity, diabetes, alcohol consumption among males are also present in India.Nonalcoholic Fatty Liver Disease (NAFLD) particularly its more aggressive form, nonalcoholic steatohepatitis (NASH) is an important factor which can lead to cirrhosis and HCC. It is estimated that nearly two-thirds of obese people have some form of fatty liver, ranging from steatosis to NASH. NASH can progress to liver cirrhosis in 3%-15% and subsequently to liver cancer. 8 A study by Prasad et al showed that age-standardized prevalence rates of metabolic syndrome were 33.5% overall, 24.9% in males and 42.3% in females in India. Authors concluded that metabolic syndrome is a significant public health problem even in one of the poorest states of India. 9 Hence NASH is particularly important in countries like India where metabolic syndrome is on the rise.It is important to note that in the absence of an effective screening program and only 7% of population being covered by cancer registries, under reporting cannot be ruled out. 10 A recent study in which 130 trained physicians independently assigned causes to 122429 deaths, which occurred in 1$1 million homes in 6671 small areas that were randomly selected to be representative of all of India, based on a structured nonmedical surveyor's field report has put the liver cancer as the 4th commonest cause of death in male and 8th commonest cause of death i...

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Cost-effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosis

Cited by 322 publications

References 51 publications

Screening for hepatocellular carcinoma

Screening for hepatocellular carcinoma

Hepatocellular carcinoma screening in patients waiting for liver transplantation: A decision analytic model

Role of Surveillance in Prevention of Hepatocellular Carcinoma

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