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HCC Screening & Survival in Patients with Cirrhosis

Clin Gastroenterol Hepatol; ePub 2018 Oct 25; Choi, et al

Hepatocellular carcinoma (HCC) screening is underused in patients with cirrhosis, contributing to detection of liver tumors at later stages and shorter times of survival, a recent study found. Researchers conducted a retrospective study of 13,174 patients diagnosed with HCC from 2003 through 2013 included in the Surveillance, Epidemiology, and End Results Program-Medicare database. Receipt of HCC screening in the 3 years before HCC diagnosis was categorized. Associations between screening receipt and overall survival were then evaluated using a Cox proportional hazards model. Among the findings:

  • More than half of patients with cirrhosis did not receive a screening in the 3 years before a diagnosis of HCC, and only 6.8% of patients underwent consistent annual screening.
  • Receipt of consistent screening was associated with detection of early-stage tumors (odds ratio [OR], 1.98) and reduced risk of death after correction for lead time bias (hazard ratio [HR], 0.76).
  • Inconsistent screening was associated with a slightly smaller increase in early detection of HCC (OR, 1.31) and reduced risk of death (HR, 0.86).
  • Higher proportions of patients with consistent and inconsistent screening survived for 3 years compared to patients without screening.


Choi DT, Kum HC, Park S, et al. Hepatocellular carcinoma screening is associated with increased survival of patients with cirrhosis. [Published online ahead of print October 25, 2018]. Clin Gastroenterol Hepatol. doi:10.1016/j.cgh.2018.10.031.