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

a-fetoprotein (AFP) and/or ultrasound test, the most commonly used modalities for HCC surveillance, during at least 2 of the 3 years prior to HCC diagnosis), inconsistent surveillance (had one or more AFP or ultrasound tests for surveillance purposes during the 3 years prior to HCC diagnosis but did not meet the criteria for regular surveillance), or no surveillance. Among 541 patients diagnosed with cirrhosis 3 or more years prior to HCC diagnosis, only 29% received routine surveillance, 33% inconsistent surveillance, while 38% had no surveillance.

Patients who were younger, Asian, diagnosed during more recent years, living in zip codes with higher income or education or in urban areas were more likely to have received regular surveillance than other groups. Women were also more likely to receive regular surveillance.

There was a distinct association between surveillance and physician characteristics. Patients seen by a gastroenterologist or hepatologist only or in combination with an internal medicine or family practice physician were 2.8 and 4.5 times, respectively, more likely to receive regular surveillance than patients seen by an internal medicine or family practice physician only. Patients whose primary physician had an academic affiliation were over 3 times more likely to receive regular surveillance than patients seen by physicians in solo practice.

"Findings from this study suggest that recommendations to monitor cirrhosis patients who are at risk for HCC have not been well adopted into clinical practice. In this population-based study, fewer than 20% of HCC patients with previously recorded cirrhosis received the recommended regular surveillance," concluded study leader Jessica Davila, Ph.D. "Future studies are needed to evaluate the knowledge, attitudes and barriers for HCC surveillance and to develop appropriate, targeted interventions to increase the dissemination of this practice."


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Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

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