Mo1490 Only One-Third of Patients With Hepatocellular Carcinoma (HCC) Were Diagnosed By Screening, Surveillance, or Without Symptoms: A Meta-Analysis of 40 Studies and 20,349 Patients With Diverse Underlying Liver Disease and World Regions

Poor adherence to hepatocellular carcinoma surveillance: A systematic review and meta‐analysis of a complex issue

“…Our subanalysis demonstrated an even lower adherence rate of 39%. A sobering estimate which may account for why only one‐third of patients present without symptoms when diagnosed with HCC‐ a statistic recently reported by Jin et al in their meta‐analysis of 40 studies and 20 349 patients …”

“…They reported an adherence rate of only 18.4% though surveillance rates were significantly higher among patients followed in subspecialty gastroenterology clinics compared to those followed in primary care clinics (51.7% vs 16.9%, P < .001). Another recent meta‐analysis reported that only one‐third of patients with HCC were diagnosed by screening, surveillance and without symptoms …”

“…Since the systematic review performed by Singal et al was conducted prior to the updated AASLD HCC surveillance guidelines where recommended screening was changed from every 6 to 12 months to every 6 months, it was apparent that an updated systematic review and meta‐analysis was necessary to determine if the new AASLD guidelines have impacted the rate of surveillance adherence. This type of review was especially necessary given the high rate of mortality of HCC when diagnosed late and as noted in Jin et al's study only 33% of patients diagnosed with HCC were actually diagnosed through surveillance suggesting that patients’ HCC was found in the later stages when curative treatment is less an option . Therefore, the purposes of this study were to perform a systematic review and meta‐analysis to estimate pooled adherence rates for at‐risk patients who were free of HCC at inclusion from diverse geographical regions and different liver disease aetiologies as well as to identify factors that may influence HCC adherence.…”

“…Another recent meta-analysis reported that only one-third of patients with HCC were diagnosed by screening, surveillance and without symptoms. 9 Since the systematic review performed by Singal et al was conducted prior to the updated AASLD HCC surveillance guidelines where recommended screening was changed from every 6 to 12 months to every 6 months, it was apparent that an updated systematic review and meta-analysis was necessary to determine if the new AASLD guidelines have impacted the rate of surveillance adherence. This type of review was especially necessary given the high rate of mortality of HCC when diagnosed late and as noted in Jin et al's study only 33% of patients diagnosed with HCC were actually diagnosed through surveillance suggesting that patients' HCC was found in the later stages when curative treatment is less an option.…”

“…This type of review was especially necessary given the high rate of mortality of HCC when diagnosed late and as noted in Jin et al's study only 33% of patients diagnosed with HCC were actually diagnosed through surveillance suggesting that patients' HCC was found in the later stages when curative treatment is less an option. 9 Therefore, the purposes of this study were to perform a systematic review and meta-analysis to estimate pooled adherence rates for at-risk patients who were free of HCC at inclusion from diverse geographical regions and different liver disease aetiologies as well as to identify factors that may influence HCC adherence.…”