Hepatocellular carcinoma surveillance in Australia: time to improve the diagnosis of cirrhosis and use liver ultrasound

Jeffrey, Gary P.; Gordon, Louisa G.; Ramm, Grant A.

doi:10.5694/mja2.50521

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…14 In Indigenous Australians with CHB at risk of HCC (age >50 or advanced fibrosis) 6-monthly surveillance with liver ultrasound is also recommended. 15 Despite the importance of CHB in remote indigenous communities, to the best of our knowledge, no study to date has examined key quality measures across the entire hepatitis B cascade of care for a remote indigenous community. In this study, we therefore undertook a review of HBV management across an entire remote indigenous community in South Australia (SA).…”

Section: Introductionmentioning

confidence: 99%

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Measuring quality of hepatitis B care in a remote Australian Aboriginal community: opportunities for improvement

Narayana

Nugent

Woodman

et al. 2022

Internal Medicine Journal

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Background Chronic hepatitis B (CHB) infection remains a significant public health issue for Indigenous Australians, in particular for remote communities. Aim To evaluate the spectrum of hepatitis B virus (HBV) care provided to a remote Aboriginal community. Measures studied included screening, seroprevalence, vaccination rates and efficacy, and HCC risk and surveillance adherence. Methods A retrospective audit of HBV care received by all permanent residents currently attending a remote Aboriginal Health service. This study was endorsed by both the local Aboriginal Health service and the Aboriginal Health Council of South Australia. Results A total of 208 patients attended the clinic, of whom 52% (109) were screened for HBV. Of these, 12% (13) had CHB and 20% (22) had evidence of past infection. Similarly, of the 208 attending patients, complete vaccination was documented in 48% (99). Of the 33 patients with post‐vaccination serology, 24% (8) had subtherapeutic (<10 IU/mL) levels of HBsAb. Subtherapeutic HBsAb was independently associated with higher Charlson Comorbidity scores (odds ratio = 17.1; 95% confidence interval 1.2–243.3; P = 0.036). Definitive breakthrough infection was identified in 6% (2) patients. One HBsAg positive patient was identified as needing HCC surveillance, but had not undertaken HCC surveillance. Conclusion Opportunities to improve the quality of CHB care through increased HBV vaccination, screening and adherence to HCC surveillance were identified. High rates of subtherapeutic vaccine responses and documented breakthrough infection raises concerns about the effectiveness of current CHB vaccines in this population.

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Section: Introductionmentioning

confidence: 99%

“…It is additionally recommended that people living with CHB are regularly monitored and antiviral therapy provided for those with active inflammation 14 . In Indigenous Australians with CHB at risk of HCC (age >50 or advanced fibrosis) 6‐monthly surveillance with liver ultrasound is also recommended 15 …”

Section: Introductionmentioning

confidence: 99%

Measuring quality of hepatitis B care in a remote Australian Aboriginal community: opportunities for improvement

Narayana

Nugent

Woodman

et al. 2022

Internal Medicine Journal

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“…Metabolic risk factors for liver cancer will continue to increase in prevalence and may become the dominant risk factor in the next 5 years in western populations. Studies reported that nonalcoholic fatty liver disease promoted the rapidly increase in the LC death [ 34 , 35 ], and unsatisfied survival for LC patients [ 7 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

The trends in death of primary liver cancer caused by specific etiologies worldwide: results from the Global Burden of Disease Study 2019 and implications for liver cancer management

et al. 2023

BMC Cancer

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Background Over past decades, epidemiological patterns of liver cancer (LC) have changed dramatically. The Global Burden of Disease (GBD) study provides an opportunity for tracking the progress in cancer control with its annual updated reports at national, regional and global level, which can facilitate the health decision-making and the allocation of health resources. Therefore, we aim to estimate the global, regional and national trends of death caused by liver cancer due to specific etiologies and attributable risks from 1990 to 2019. Materials and methods Data was collected from the GBD study 2019. Estimated annual percentage changes (EAPC) were used to quantify the trends of age-standardized death rate (ASDR). We applied a linear regression for the calculation of estimated annual percentage change in ASDR. Results From 1990 to 2019, the ASDR of liver cancer decreased globally (EAPC = − 2.23, 95% confidence interval [CI]: − 2.61 to − 1.84). Meanwhile, declining trends were observed in both sexes, socio-demographic index (SDI) areas, and geographies, particularly East Asia (EAPC = − 4.98, 95% CI: − 5.73 to − 4.22). The ASDR for each of the four major etiologies fell globally, while liver cancer caused by hepatitis B had the largest drop (EPAC = − 3.46, 95% CI: − 4.01 to − 2.89). China has had dramatic decreases in death rates on a national scale, particularly when it comes to the hepatitis B etiology (EAPC = − 5.17, 95% CI: − 5.96 to − 4.37). However, certain nations, such as Armenia and Uzbekistan, saw a rise in liver cancer mortality. Controlling smoking, alcohol, and drug use contributed to a drop in LC-related mortality in the majority of socio-demographic index areas. Nevertheless, the excessive body mass index (BMI) was portrayed as the underlying cause for LC fatalities. Conclusion From 1990 to 2019, there was a worldwide decrease in deaths caused by liver cancer and its underlying causes. However, rising tendencies have been observed in low-resource regions and countries. The trends in drug use- and high BMI-related death from liver cancer and its underlying etiologies were concerning. The findings indicated that efforts should be increased to prevent liver cancer deaths through improved etiology control and risk management.

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“…Increasing trends of death caused by LCNA were seen in most geographic regions, particularly in Australasia and Central Asia region. Studies reported that nonalcoholic fatty liver disease promoted the rapidly increase in the LC death [35,36], and unsatis ed survival for LC patients [8,37]. High fasting plasma glucose-related caused by LCNA had increasing trends in high SDI and low SDI area, which probably were explained by the high prevalence of obesity, and metabolic syndromes in these areas [38].…”

Section: Trends In Underlying Etiologies Attributable Risks-related D...mentioning

confidence: 99%

The trends in death of primary liver cancer caused by specific etiologies worldwide: results from the Global Burden of Disease Study 2019 and implications for liver cancer management

et al. 2022

Preprint

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Background: Over past decades, epidemiological patterns of liver cancer (LC) have changed dramatically. The Global Burden Of Disease (GBD) study provides an opportunity to tracking the progress in cancer control with its annual updated reports at national, regional, global level, which can facilitate the health decision-making and the allocation of health resources. Therefore, we aim to estimate the global, regional and national trends of death caused by liver cancer due to specific etiologies and attributable risks from 1990 to 2019. Materials and Methods: Data was collected from the GBD study 2019. Estimated annual percentage changes (EAPC) were used to quantify the trends of age-standardized death rate (ASDR). We applied a linear regression for the calculation of estimated annual percentage change in ASDR. Results: From 1990 to 2019, the ASDR of liver cancer decreased globally (EAPC = −2.23, 95% confidence interval [CI]: −2.61 to −1.84). Meanwhile, declining trends were observed in both sexes, socio-demographic index (SDI) areas, and geographies, particularly East Asia (EAPC =−4.98, 95%CI: −5.73 to −4.22). The ASDR for all four major etiologies decreased globally, particularly LC owing to hepatitis B (EPAC = −3.46, 95% CI: −4.01 to −2.89). At the national level, China has seen dramatic decreases in death rates, particularly in the etiology of hepatitis B (EAPC = −5.17, 95% CI: −5.96 to −4.37). However, mortality from liver cancer increased in certain countries, including Armenia and Uzbekistan. Controlling smoking, alcohol, and drug use contributed to a drop in LC-related mortality in the majority of socio-demographic index areas. However, the excessive BMI was portrayed as the underlying cause for LC fatalities. Conclusion: From 1990 to 2019, there was a worldwide decrease in deaths caused by liver cancer and its underlying causes. However, rising tendencies have been observed in low-resource regions and countries. The trends in drug use- and high BMI-related death from liver cancer and its underlying etiologies were concerning. The findings indicated that efforts should be increased to prevent liver cancer deaths through improved etiology control and risk management.

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Hepatocellular carcinoma surveillance in Australia: time to improve the diagnosis of cirrhosis and use liver ultrasound

Cited by 6 publications

References 18 publications

Measuring quality of hepatitis B care in a remote Australian Aboriginal community: opportunities for improvement

Measuring quality of hepatitis B care in a remote Australian Aboriginal community: opportunities for improvement

The trends in death of primary liver cancer caused by specific etiologies worldwide: results from the Global Burden of Disease Study 2019 and implications for liver cancer management

The trends in death of primary liver cancer caused by specific etiologies worldwide: results from the Global Burden of Disease Study 2019 and implications for liver cancer management

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