Patient-Reported Barriers Are Associated With Receipt of Hepatocellular Carcinoma Surveillance in a Multicenter Cohort of Patients With Cirrhosis

Singal, Amit G.; Tiro, Jasmin A.; Murphy, Caitlin C.; Blackwell, James Michael; Kramer, Jennifer R.; Khan, Aamir Z.; Liu, Yan; Zhang, Song; Phillips, Jessica; Hernáez, Rubén

doi:10.1016/j.cgh.2020.06.049

Cited by 80 publications

(70 citation statements)

References 34 publications

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“…20,21 Finally, ultrasound-based surveillance programs often require a separate appointment, creating potential barriers to adherence, contributing to underuse of HCC surveillance in clinical practice, occurring in less than 50% across geographic regions. 22,23 Overall, the limitations of our current strategy highlight a strong need for alternative surveillance tests, particularly highly accurate bloodbased biomarkers.…”

Section: Early Detectionmentioning

confidence: 99%

International Liver Cancer Association (ILCA) White Paper on Biomarker Development for Hepatocellular Carcinoma

et al. 2021

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Section: Early Detectionmentioning

confidence: 99%

International Liver Cancer Association (ILCA) White Paper on Biomarker Development for Hepatocellular Carcinoma

et al. 2021

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“…In Thailand, the universal medical coverage scheme supports HCC surveillance program for all high-risk patients, which relieves most of the patients' nancial concerns. This has also been observed in the United States among patients with stable health insurance enrollment who have reported less nancial concern 22 . This underscores the critical role that health coverage can play in increasing the rate of HCC surveillance.…”

Section: Discussionmentioning

confidence: 65%

Physician-and patient-reported barriers to hepatocellular carcinoma surveillance: a nationwide survey

Teerasarntipan

Sritunyarat

Prathyajuta

et al. 2021

Preprint

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Background Hepatocellular carcinoma (HCC) surveillance rates are suboptimal. We aimed to identify HCC surveillance barriers from both physician and patient perspectives and assess the effectiveness of physician education using social networks. Methods A nationwide survey with 513 physicians and another single-center survey with 315 HCC-risk patients were conducted. Regression analysis was used to identify surveillance barriers. We educated 143 physicians by sending brief notes on HCC surveillance guidelines via social networks and re-evaluated their knowledge at 60 days using paired T-test.Results Surveys showed 458 (86.3%), 254 (47.8%) and 225 (42.4%) physicians recommended surveillance in patients with cirrhosis, at-risk HBV and HCV infection, respectively. Only 228 (42.9%) and 241 (38.0%) respondents adhered to recommended surveillance tools and interval, respectively. The main surveillance barriers among physicians were the lack of knowledge and resource limitations. The lack of a doctor’s prescription was identified as main barrier by patients (relative risk 1.4, 95%CI 1.1-1.8, p=0.024). Social networks education enhanced physicians’ knowledge pre-and post-education scores for guideline awareness: (63.0%vs.84.3%, p<0.001) and surveillance indication (40.0%vs.63.0%, p=0.001). Conclusions Physicians’ knowledge gap was primary barrier for adherence to HCC surveillance protocols. Brief education via social networks showed effectiveness at increasing knowledge of HCC surveillance with medical residents.Clinical trial registry: This study was registered to the Thai clinical trial registry (TCTR number 20210127006). Registered 22 July 2021- Retrospectively registered. http://www.clinicaltrials.in.th/

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“…In a multi-centre study that analyzed liver cancer surveillance compliance in 1,020 patients with cirrhosis, the results indicated that surveillance was not required for most patients if routine examination was normal or asymptomatic. 73.1% of patients received surveillance more than once, of these, 37.7% were under surveillance twice a year and were associated with hepatologists (OR: 30.1, 95%CI: 17.5-51.8), while 50% reported difficulties with surveillance, including cost (28.9%), time (24.1%), and traffic (17.8%) [126] . Similarly, in a cohort of chronic hepatitis C patients under long-term treatment, there was no screening in 13%, no follow-up in 17% and no surveillance in 70% of patients who developed advanced liver cancer [127] .…”

Section: Compliance For Patientsmentioning

confidence: 99%

Guideline for stratified screening and surveillance in patients with high risk of primary liver cancer (2020)

Ding¹,

Tu²,

Qu³

et al. 2021

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Patient-Reported Barriers Are Associated With Receipt of Hepatocellular Carcinoma Surveillance in a Multicenter Cohort of Patients With Cirrhosis

Cited by 80 publications

References 34 publications

International Liver Cancer Association (ILCA) White Paper on Biomarker Development for Hepatocellular Carcinoma

International Liver Cancer Association (ILCA) White Paper on Biomarker Development for Hepatocellular Carcinoma

Physician-and patient-reported barriers to hepatocellular carcinoma surveillance: a nationwide survey

Guideline for stratified screening and surveillance in patients with high risk of primary liver cancer (2020)

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