- Additional Authors
- Series Statement
- Evidence-based synthesis program
- Uniform Title
- Evidence-based synthesis program (Series)
- Subject
- Genre/Form
- Technical reports
- Technical reports.
- Note
- Bibliography (note)
- Includes bibliographical references (pages 23-29).
- Funding (note)
- Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center, Portland, OR, Devan Kansagara, M.D., M.C.R., Director.
- VA-ESP
- Source of Description (note)
- Description based on online resource; title from PDF cover (VA, viewed March 22, 2021).
- Call Number
- GPO Internet VA 1.107/3:H 41
- OCLC
- 898325894
- Author
Kansagara, Devan, author.
- Title
Screening for hepatocellular cancer in chronic liver disease : a systematic review / principal investigators, Devan Kansagara, Janice H. Jou ; co-investigators, Joel Papak, Amirala S. Pasha, Maya O'Neil, Michele Freeman, Rose Relevo, Ana Quinones, Makalapua Motu'apuaka.
- Publisher
Washington, DC : Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, January 2014.
- Description
1 online resource (iii, 61 pages) : illustrations (some color).
- Type of Content
text
- Type of Medium
computer
- Type of Carrier
online resource
- Series
Evidence-based synthesis program
Evidence-based synthesis program (Series)
- Bibliography
Includes bibliographical references (pages 23-29).
- Summary
In the Veterans Health Administration (VHA), there has been a marked increase in the prevalence of cirrhosis from chronic hepatitis C infection with a corresponding increase in the number of hepatocellular cancer (HCC) diagnoses. From 1996 to 2006, the prevalence of cirrhosis among Veterans with chronic hepatitis C infection rose from 9 to 18.5%, and the prevalence of HCC rose from 0.07 to 1.3%. In the general population, the incidence of HCC rose between 1992 and 2005 from 3.1/100,000 to 5.1/100,000, with localized tumors accounting for most of the increase. While, on average, the 5-year survival of HCC is low (13 to 16.5%), the survival of early-stage disease has risen. The rationale for screening is that imaging tests such as ultrasound can identify patients with early stage HCC and there are several potentially curative treatment options for patients with early stage HCC including liver transplantation, radiofrequency ablation, and liver resection. Several professional society guidelines currently recommend HCC screening using imaging studies and tumor markers mainly in patients with chronic hepatitis B or liver cirrhosis. However, recommendations for HCC screening remain controversial in part because of concerns over the quality and paucity of existing evidence, and because there have been concerns raised about overdiagnosis and patient harms in other cancer screening programs. We conducted a systematic review of the published literature to better understand the incremental benefits and harms of routine HCC screening in patients with chronic liver disease compared to clinical or incidental diagnosis. We looked for direct evidence of the health outcome effects of screening. We also looked for indirect evidence of the effects of screening by evaluating studies examining the health outcome benefits and harms of treating early-stage HCC which, because the intent and result of routine screening is detection of early-stage disease, is a proxy for screen-detected disease.
- Funding
Prepared for: Department of Veterans Affairs, Veterans Health Administration, Health Services Research & Development Service, Washington, DC 20420. Prepared by: Evidence-based Synthesis Program (ESP) Center, Portland VA Medical Center, Portland, OR, Devan Kansagara, M.D., M.C.R., Director.
VA-ESP 05-225
- Connect to:
- Added Author
Jou, Janice H., author.
United States. Department of Veterans Affairs. Health Services Research and Development Service, issuing body.
Portland VA Medical Center. Evidence-based Synthesis Program Center.
Quality Enhancement Research Initiative (U.S.)
- Gpo Item No.
0985-A-12 (online)
- Sudoc No.
VA 1.107/3:H 41
- Research Call Number
GPO Internet VA 1.107/3:H 41