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Study finds poor compliance with cirrhosis surveillance recommendations
Date:6/9/2010

A study conducted by researchers at the Baylor College of Medicine found that fewer than 20% of patients with hepatocellular carcinoma (HCC) preceded by cirrhosis were monitored for the development of cancer. Full findings of this study are published in the July issue of Hepatology, a journal of the American Association for the Study of Liver Diseases (AASLD).

According to the National Cancer Institute, HCC is the fourth most common cancer in the world. In the U.S., 22,620 new cases of HCC were diagnosed and 18,160 deaths due to this disease occurred in 2009. Most patients with HCC are diagnosed at an advanced stage of disease when survival is poor, but if patients are diagnosed early, survival rates improve considerably. The AASLD recommend HCC surveillance in patients with cirrhosis who are at high risk of developing HCC. However, population-based studies in the U.S. indicate that only 11% of patients with HCC are diagnosed early enough to receive potentially curative treatments.

Given the escalating incidence of HCC-related deaths, the extent of HCC surveillance in clinical practice is unclear. The study team evaluated HCC surveillance in 1,873 patients diagnosed with HCC who had a prior diagnosis of cirrhosis during 1994-2002 using data obtained from the linked Surveillance, Epidemiology, and End-Results (SEER) -Medicare claims. Several potential determinants of HCC surveillance, including patient, clinical, and physician factors were also examined. The mean age at HCC diagnosis was 74.9 years and most patients were male (65.7%). The largest proportion of patients was white, followed by Hispanic, Asian, and black. Approximately 37% had a recorded diagnosis of cirrhosis for more than 2-years prior to their HCC diagnosis. The mean number of physician visits within the 3-years prior to HCC was 67.9.

Patients were categorized into three mutually exclusive groups as receiving regular surveillance (had an annual serum alph
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Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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