HCC Surveillance Program for Patients With Hepatitis C Cirrhosis

A population-based hepatocellular cancer (HCC) surveillance program significantly enhanced surveillance utilization and improved clinical outcomes for patients with hepatitis C virus cirrhosis, according to a study published in The American Journal of Gastroenterology.

Researchers analyzed the surveillance patterns of 597 patients enrolled in an integrated health system's program between 2013 and 2020. Surveillance adequacy was defined as at least 5 surveillance studies within 36 months before and after enrollment. The study also assessed the proportion of time covered by surveillance and compared tumor characteristics, stage, and treatment outcomes between HCC cases detected during the first imaging (prevalent HCC) and those identified through ongoing surveillance (incident HCC).

The results demonstrated a significant improvement in surveillance completion (77.6% postenrollment vs. 5.0% pre-enrollment, P < 0.001) and proportion time covered (80.9% vs. 15.8%, P < 0.001) after the program's implementation. Surveillance-detected HCC cases were more likely to be unifocal (77.8% vs. 44.8%, P < 0.001), early-stage (85.2% vs. 44.8%, P < 0.001), and had smaller tumors (median size 2.3 cm vs. 3.2 cm). Additionally, patients with incident HCC were more likely to receive curative therapy (92.5% vs. 72.4%, P = 0.010) and showed improved survival compared to prevalent cases (hazard ratio 0.23 after adjustment for age and Model for End-Stage Liver Disease score).

Researchers concluded that these findings suggest that similar programs could be beneficial if implemented in other health care systems.

Reference
Bui H, Kumar NG, Singal AG, et al. Implementation of a hepatocellular carcinoma surveillance program in a community-based integrated health system in patients with hepatitis c cirrhosis. Am J Gastroenterol. 2024;119(8):1506-1514. doi:10.14309/ajg.0000000000002704