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Article: Application of surveillance programs for hepatocellular carcinoma in the Asia-Pacific Region

TitleApplication of surveillance programs for hepatocellular carcinoma in the Asia-Pacific Region
Authors
Issue Date2009
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGH
Citation
Journal of Gastroenterology and Hepatology, 2009, v. 24 n. 6, p. 955-961 How to Cite?
AbstractHepatocellular carcinoma (HCC) is a potential target for cancer surveillance (or screening) as it occurs in well-defined, at-risk populations and curative therapy is possible only for small tumors. Surveillance has been recommended by regional liver societies and is practiced widely, but its benefits are not clearly established. Hepatic ultrasonography with or without alpha fetoprotein (AFP) performed every 6 months is the preferred program. Surveillance of HCC has been well shown to detect small tumors for curative treatment, which may be translated to improved patient survival. However, most studies are limited by lead-time bias, length bias for early diagnosis of small HCC, different tumor growth rates and poor compliance with surveillance. Cost-effectiveness of surveillance programs depends on the rate of small HCC detected 'accidentally' (routine imaging) in a comparator group, annual incidence of HCC with various etiologies, patient age and the availability of liver transplantation. The incremental cost-effectiveness for 6-monthly AFP and ultrasound has been estimated from approximately $US 26,000-74,000/quality adjusted life years (QALY). All cirrhotic patients are therefore recommended for HCC surveillance unless the disease is too advanced for any curative treatment. As chronic hepatitis B can develop into HCC without going through liver cirrhosis, high-risk non-cirrhotic chronic hepatitis B patients are also recommended for HCC surveillance. In conclusion, HCC surveillance could be effective at reducing disease-specific mortality with acceptable cost-effectiveness among selected patient groups, provided it is a well-organized program.
Persistent Identifierhttp://hdl.handle.net/10722/59334
ISSN
2015 Impact Factor: 3.322
2015 SCImago Journal Rankings: 1.190
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorAmarapurkar, Den_HK
dc.contributor.authorHan, KHen_HK
dc.contributor.authorChan, HLYen_HK
dc.contributor.authorUeno, Yen_HK
dc.contributor.authorYuen, RMFen_HK
dc.date.accessioned2010-05-31T03:47:55Z-
dc.date.available2010-05-31T03:47:55Z-
dc.date.issued2009en_HK
dc.identifier.citationJournal of Gastroenterology and Hepatology, 2009, v. 24 n. 6, p. 955-961en_HK
dc.identifier.issn0815-9319en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59334-
dc.description.abstractHepatocellular carcinoma (HCC) is a potential target for cancer surveillance (or screening) as it occurs in well-defined, at-risk populations and curative therapy is possible only for small tumors. Surveillance has been recommended by regional liver societies and is practiced widely, but its benefits are not clearly established. Hepatic ultrasonography with or without alpha fetoprotein (AFP) performed every 6 months is the preferred program. Surveillance of HCC has been well shown to detect small tumors for curative treatment, which may be translated to improved patient survival. However, most studies are limited by lead-time bias, length bias for early diagnosis of small HCC, different tumor growth rates and poor compliance with surveillance. Cost-effectiveness of surveillance programs depends on the rate of small HCC detected 'accidentally' (routine imaging) in a comparator group, annual incidence of HCC with various etiologies, patient age and the availability of liver transplantation. The incremental cost-effectiveness for 6-monthly AFP and ultrasound has been estimated from approximately $US 26,000-74,000/quality adjusted life years (QALY). All cirrhotic patients are therefore recommended for HCC surveillance unless the disease is too advanced for any curative treatment. As chronic hepatitis B can develop into HCC without going through liver cirrhosis, high-risk non-cirrhotic chronic hepatitis B patients are also recommended for HCC surveillance. In conclusion, HCC surveillance could be effective at reducing disease-specific mortality with acceptable cost-effectiveness among selected patient groups, provided it is a well-organized program.-
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/JGHen_HK
dc.relation.ispartofJournal of Gastroenterology and Hepatologyen_HK
dc.rightsThe definitive version is available at www3.interscience.wiley.com-
dc.subject.meshCarcinoma, Hepatocellular - diagnosis - economics - epidemiology-
dc.subject.meshHepatitis B, Chronic - complications - epidemiology-
dc.subject.meshHepatitis C, Chronic - complications - epidemiology-
dc.subject.meshLiver Neoplasms - diagnosis - economics - epidemiology-
dc.subject.meshPopulation Surveillance - methods-
dc.titleApplication of surveillance programs for hepatocellular carcinoma in the Asia-Pacific Regionen_HK
dc.typeArticleen_HK
dc.identifier.emailYuen, RMF: mfyuen@hkucc.hku.hken_HK
dc.identifier.authorityYuen, RMF=rp00479en_HK
dc.identifier.doi10.1111/j.1440-1746.2009.05805.x-
dc.identifier.pmid19383082-
dc.identifier.scopuseid_2-s2.0-66549114663-
dc.identifier.hkuros160999en_HK
dc.identifier.volume24-
dc.identifier.issue6-
dc.identifier.spage955-
dc.identifier.epage961-
dc.identifier.isiWOS:000266465000007-
dc.publisher.placeAustralia-

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