O8 Optimal liver cancer surveillance in the community: do recall and reminder systems hold the answer?

Allard, Nicole; Cabrie, T.; Wheeler, Emily; MacLachlan, Jennifer H; Cowie, Benjamin C

doi:10.1016/s2055-6640(20)30891-8

Cited by 7 publications

(13 citation statements)

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“…(27) We found only three Australian publications investigating liver cancer. (28)(29)(30) While, the proportion of lung cancer publications identified in this study is comparable to current broader lung cancer research, representing only 6.5% of cancer research. (31) This small percentage does not align with the global burden of lung cancer; as the second most commonly diagnosed cancer and the leading cause of cancer death.…”

Section: Comparison With Existing Literaturementioning

confidence: 56%

General practice-based cancer research publications: a bibliometric analysis 2013–2019

et al. 2022

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Background: General practice plays a critical role in the prevention, diagnosis, management, and survivorship care of cancer patients. Mapping research outputs over time provides valuable insights into the evolving role of general practice in cancer care. Aim: To describe and compare the distribution of cancer in general practice research publications by country, cancer type, area of the cancer continuum, author gender and journal impact factor. Design and setting: Bibliometric analysis. Methods: MEDLINE and EMBASE databases were searched for studies published between 2013-2019, that reported on cancer in general practice. Included studies were mapped to the cancer continuum framework. Descriptive statistics were used to present data from the included studies. Results: We included 2798 publications from 714 journals, spanning 79 countries. The publication rate remained stable over this period. Overall, the United States of America produced the most publications, although per general population capita, Denmark produced ten times more publications. Research across the cancer continuum varied by country, but overall, the majority of studies focused on cancer screening, diagnosis and survivorship. More than half of included studies used observational study designs. Females made up 66.5% of first authors, but only 47.0% of last authors. Conclusion: Cancer in general practice is a stable field where research is predominately observational. There is geographical variation in the focus of cancer in general practice research which may reflect different priorities and levels of investment between countries. Overall, these results support future consideration of how to improve under-represented research areas and the design, conduct, and translation of interventional resear

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Section: Comparison With Existing Literaturementioning

confidence: 56%

General practice-based cancer research publications: a bibliometric analysis 2013–2019

et al. 2022

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“…However, although over 70% of the cohort that were eligible for HCC surveillance received an ultrasound in the prior 12 months, it was notable that despite the high burden of risk factors for HCC, there was only a single confirmed case of HCC in the cohort. Whilst incomplete screening raises the possibility of underdiagnosis, screening rates (during a period impacted significantly by the global COVID-19 pandemic) were not worse than those reported in Australian metropolitan settings [ 67 ].…”

Section: Discussionmentioning

confidence: 99%

The high burden of comorbidities in Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B in Far North Queensland, Australia, and the implications for patient management

Riddell

Hempenstall²,

Nakata³

et al. 2023

PLoS ONE

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Background Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B virus (HBV) infection have a significant burden of hepatocellular carcinoma (HCC). The prevalence of comorbidities that increase the risk of HCC in this population is incompletely defined. Methods This cross-sectional study was performed in remote tropical Queensland, Australia in January 2021. All individuals living with chronic HBV in the region were identified; the prevalence of relevant comorbidities was determined by reviewing medical records. Results All 236 individuals in the cohort identified as Aboriginal and Torres Strait Islander Australians; their median (interquartile range (IQR)) age was 48 (40–62) years; 120/236 (50.9%) were female. Of the 194/236 (82.2%) engaged in HBV care, 61 (31.4%) met criteria for HBV therapy and 38 (62.2%) were receiving it. However, 142/236 (60.2%) were obese, 73/236 (30.9%) were current smokers and 57/236 (24.2%) were drinking alcohol hazardously; 70/236 (29.7%) had ≥2 of these additional risk factors for HCC, only 43/236 (18.2%) had none. Among the 19 patients with confirmed cirrhosis, 9 (47%) were obese, 8 (42%) were currently—or had a history of—drinking alcohol hazardously and 5 (26.3%) were current smokers. Patients also had a median (IQR) of 3 (2–4) cardiovascular risk factors (cigarette smoking, hypertension, impaired glucose tolerance, dyslipidaemia, renal impairment/proteinuria). Only 9/236 (3.8%) did not have one of these 5 comorbidities. Conclusions Aboriginal and Torres Strait Islander Australians living with chronic HBV in this region of remote Australia have a high engagement with HBV care and the majority of individuals eligible for antiviral therapy are receiving it. However, a significant comorbidity burden increases their risk of cirrhosis, HCC, and premature death. It is essential to integrate chronic HBV care with management of these comorbidities—rather than focusing on HBV alone—to achieve optimal health outcomes.

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“…First, Goldberg’s study encompassed patients followed-up in both community or specialist practices, and found that number of specialist visits was the strongest predictor for greater surveillance participation[ 7 ]. Adherence rates for those in non-specialist care have historically been low, with international and limited local data showing optimal surveillance uptake of only 8.8%-27%[ 3 , 20 , 21 ]. Specialist input may serve as a surrogate marker for greater frequency of reminders for test follow-up, may select for a group of patients more engaged with healthcare, or indicate more unwell patients undergoing imaging for reasons other than surveillance[ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma surveillance and quantile regression for determinants of underutilisation in at-risk Australian patients

Low¹,

Apostolov²,

Wong³

et al. 2021

WJGO

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BACKGROUND While clinical guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, reported surveillance rates in the United States and Europe remain disappointingly low. AIM To quantify HCC surveillance in an Australian cohort, and assess for factors associated with surveillance underutilisation. METHODS All patients undergoing HCC surveillance liver ultrasounds between January 1, 2018 to June 30, 2018 at a tertiary hospital in Melbourne, Australia, were followed until July 31, 2020, or when surveillance was no longer required. The primary outcome was the percentage of time up-to-date with HCC surveillance (PTUDS). Quantile regression was performed to determine the impact of factors associated with HCC surveillance underutilisation. RESULTS Among 775 at-risk patients followed up for a median of 27.5 months, the median PTUDS was 84.2% (IQR: 66.3%-96.3%). 85.0% of patients were followed up by specialist gastroenterologists. Amongst those receiving specialist care, quantile regression demonstrated differential associations at various quantile levels of PTUDS for several factors. Older age at the 25 th quantile (estimate 0.002 per percent, P = 0.03), and cirrhotic status at the 75 th quantile (estimate 0.021, P = 0.017), were significantly associated with greater percentage of time up-to-date. African ethnicity (estimate -0.089, P = 0.048) and a culturally and linguistically diverse (CALD) background (estimate -0.063, P = 0.01) were significantly associated with lower PTUDS at the 50 th quantile, and again for CALD at the 75 th quantile (estimate -0.026, P = 0.045). CONCLUSION While median PTUDS in this Australian cohort study was 84.2%, awareness of the impact of specific factors across PTUDS quantiles can aid targeted interventions towards improved HCC surveillance.

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O8 Optimal liver cancer surveillance in the community: do recall and reminder systems hold the answer?

Cited by 7 publications

References 0 publications

General practice-based cancer research publications: a bibliometric analysis 2013–2019

General practice-based cancer research publications: a bibliometric analysis 2013–2019

The high burden of comorbidities in Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B in Far North Queensland, Australia, and the implications for patient management

Hepatocellular carcinoma surveillance and quantile regression for determinants of underutilisation in at-risk Australian patients

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