Practice, Knowledge, and Barriers for Screening of Hepatocellular
                        Carcinoma Among High-Risk Chinese Patients

Xu, Kerui; Watanabe‐Galloway, Shinobu; Rochling, Fedja A.; Zhang, Jianjun; Farazi, Paraskevi A.; Peng, Hongyan; Wang, Hongmei; Luo, Jiangtao

doi:10.1016/j.aogh.2017.02.002

Cited by 20 publications

(39 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An estimated figure has shown that less than 5% of rural patients are able to afford 1 year of treatment as opposed to 40% of patients in more developed regions [29]. In addition to issues concerning accessibility and costs of treatment, Chinese patients in rural regions also have poor health awareness; many infected-individuals are unaware of their HBV infection until symptoms appear [31,32]. …”

Section: Discussionmentioning

confidence: 99%

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Liu

Farazi

et al. 2018

Global Health Action

Self Cite

View full text Add to dashboard Cite

Background: Globally, of the 248 million people chronically infected with the hepatitis B virus (HBV), 74 million reside in China. Five oral nucleot(s)ide analogs (NUCs) have been approved for the treatment of chronic hepatitis B (CHB) in China. Objectives: The aims of this study were to determine rates of adherence to NUC therapy in patients with CHB, to identify the self-perceived barriers to adherence, and to examine the factors associated with adherence. Methods: Questionnaire-based interviews were administered among Chinese patients with CHB at hepatology clinics of a tertiary hospital in the city of Wuhan, China. Adults aged 18 years or older prescribed with NUCs were recruited and interviewed to complete a 27-item questionnaire in a private setting, and adherence was measured using the Morisky Medication Adherence Scale (MMAS-8). Results: Among 369 participants, only 16.5% had high adherence (score of 8), 32.2% had medium adherence (score of 6 to <8), and 51.2% were measured with low adherence (score of <6). A logistic regression model was used to determine the factors associated with medication adherence. Significant predictors of high adherence consisted of urban residency, non-cirrhotic status, not using prescribed pills other than HBV medications, and reminders from family members. The five most common reasons for skipping NUCs were that medication(s) are expensive (48.7%), forgetfulness (45.1%), have experienced or worry about potential side effects (19.8%), do not want others to know about my medication(s) usage (18.5%), and ran out of pills and do not have time to refill (15.9%). Conclusions: This study revealed that adherence rates to oral antiviral therapy were far from optimal. This finding should generate public attention, and it would be beneficial for interventional programs to target Chinese patients from rural regions, as well as patients with low socioeconomic status, cirrhosis, and taking multiple medications.

show abstract

Section: Discussionmentioning

confidence: 99%

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Liu

Farazi

et al. 2018

Global Health Action

Self Cite

View full text Add to dashboard Cite

show abstract

“…The HCC-related knowledge section was modified from previous studies 18 – 20 under consultation with six liver disease experts. This section contained 13 statements each with three choices: “aware”, “uncertain”, and “unaware” ( Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…Questions were adapted from earlier validated surveys. 18 , 20 , 21 After pretesting the questionnaire on 20 patients, necessary modifications were made. Finally, 10 items of possible barriers were finalized: financial issue, accuracy of the surveillance, inadequate information on the place to receive tests as part of the surveillance procedure, the necessity of surveillance, appointment difficulties, time commitment, transportation, lack of a specialist, fear of finding cancer, and fear of pain.…”

Section: Methodsmentioning

confidence: 99%

“…The selection was guided by a theoretical model of patient behavior for HCC surveillance based on the Health Behavior Framework. 17 The HCC-related knowledge section was modified from previous studies [18][19][20] under consultation with six liver disease experts. This section contained 13 statements each with three choices: "aware", "uncertain", and "unaware" ( Table 1).…”

Section: Data Collectionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Adherence to Hepatocellular Carcinoma Surveillance and Perceived Barriers Among High-Risk Chronic Liver Disease Patients in Yunnan, China</p>

Dai¹,

Zhao²,

Du³

et al. 2020

CMAR

View full text Add to dashboard Cite

Background: Data concerning adherence to hepatocellular carcinoma (HCC) surveillance among chronic liver disease (CLD) patients at high risk of developing HCC in China are limited. We aimed to examine the relationship between HCC-related knowledge dimensions and adherence to HCC surveillance procedures among chronic liver disease patients at high risk of developing HCC and to identify potential barriers. Methods: A total of 380 patients with chronic liver disease at high risk of developing HCC were recruited between May and August 2018 to complete a survey during the first week of their first hospitalization at the Third People's Hospital of Kunming in China. We followed up each patient up to 7 months by telephone to confirm whether the patient returned to complete investigations for HCC surveillance. Patient's socio-demographic characteristics, HCC-related knowledge, and perceived barriers to HCC surveillance were measured using a structured questionnaire during their hospitalization. Factor analysis was performed on the knowledge questions to reduce the dimensions. Univariate and multivariate analyses were performed to examine the association between dimensions of HCC-related knowledge and patients' adherence to HCC surveillance. Results: A total of 327 eligible patients had been successfully contacted in the follow-up phase. Only a quarter of patients completed HCC surveillance within 7 months after their first admission to hospital. High costs and perceived poor test efficacy were the two major barriers for HCC surveillance. Three common factors were derived from the factor analysis of HCCrelated knowledge, namely, "Surveillance", "Lifestyle", and 'Prognosis'. Knowledge of HCC surveillance and lifestyle but not prognosis had an influence on adherence to HCC surveillance. Patients with better surveillance and lifestyle knowledge domain had better adherence to HCC surveillance. Conclusion: Adherence to HCC surveillance procedures is low in the study area. Closing the gap in HCC-related knowledge, particularly regarding surveillance and lifestyle, may help to increase adherence rates.

show abstract

“…1,2 Currently, the most widely used diagnostic methods for HCC screening include biannual abdominal ultrasound examination and serum alphafetoprotein measurement. 3 In the United States, all focal liver lesions suspected during ultrasound examination are verified using computed tomography and/or magnetic resonance imaging. 4 The application of these methods makes the diagnosis of HCC a lot more accurate, in which the sensitivity of diagnosis is up to 89% and the specificity reaches as high as 99%.…”

Section: Introductionmentioning

confidence: 99%

<p>Screening and Identification of Potential Biomarkers for Hepatocellular Carcinoma: An Analysis of TCGA Database and Clinical Validation</p>

Wei

Huang

et al. 2020

CMAR

View full text Add to dashboard Cite

Introduction: Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world. Up to now, many genes associated with HCC have not yet been identified. In this study, we screened the HCC-related genes through the integrated analysis of the TCGA database, of which the potential biomarkers were also further validated by clinical specimens. The discovery of potential biomarkers for HCC provides more opportunities for diagnostic indicators or gene-targeted therapies. Methods: Cancer-related genes in The Cancer Genome Atlas (TCGA) HCC database were screened by a random forest (RF) classifier based on the RF algorithm. Proteins encoded by the candidate genes and other associated proteins obtained via protein-protein interaction (PPI) analysis were subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses. The newly identified genes were further validated in the HCC cell lines and clinical tissue specimens by Western blotting, immunofluorescence, and immunohistochemistry (IHC). Survival analysis verified the clinical value of genes. Results: Ten genes with the best feature importance in the RF classifier were screened as candidate genes. By comprehensive analysis of PPI, GO and KEGG, these genes were confirmed to be closely related to HCC tumors. Representative NOX4 and FLVCR1 were selected for further validation by biochemical analysis which showed upregulation in both cancer cell lines and clinical tumor tissues. High expression of NOX4 or FLVCR1 in cancer cells predicts low survival. Conclusion: Herein, we report that NOX4 and FLVCR1 are promising biomarkers for HCC that may be used as diagnostic indicators or therapeutic targets.

show abstract

Practice, Knowledge, and Barriers for Screening of Hepatocellular Carcinoma Among High-Risk Chinese Patients

Cited by 20 publications

References 37 publications

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

Adherence and perceived barriers to oral antiviral therapy for chronic hepatitis B

<p>Adherence to Hepatocellular Carcinoma Surveillance and Perceived Barriers Among High-Risk Chronic Liver Disease Patients in Yunnan, China</p>

<p>Screening and Identification of Potential Biomarkers for Hepatocellular Carcinoma: An Analysis of TCGA Database and Clinical Validation</p>

Contact Info

Product

Resources

About