Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Screening for hepatocellular carcinoma in chronic liver disease

This month's issue of the Annals of Internal Medicine reviews the benefits and harms of HCC screening in patients with chronic liver disease.

News image

Guidelines recommend routine screening for hepatocellular carcinoma (HCC) in high-risk patients, but the strength of evidence supporting these recommendations is unclear.

Dr Devan Kansagara and colleagues reviewed the benefits and harms of HCC screening in patients with chronic liver disease.

MEDLINE, PsycINFO, and ClinicalTrials.gov were searched from inception to 2014, including Cochrane databases to 2013, reference lists, and technical advisors.

English-language trials and observational studies comparing screening versus no screening were identified, as well as studies of harms, and trials comparing different screening intervals.

The team evaluated mortality and adverse events.

The overall strength of evidence on the effects of screening was very low
Annals of Internal Medicine

Individual-study quality and the overall strength of evidence were dual-reviewed using published criteria.

Of 13,801 citations, 22 studies met inclusion criteria.

The researchers found that the overall strength of evidence on the effects of screening was very low.

One large trial of patients with hepatitis B found decreased HCC mortality with periodic ultrasonographic screening, but the study was limited by methodological flaws.

Another trial in patients with hepatitis B found no survival benefit with periodic α-fetoprotein screening.

The team noted that in 18 observational studies, screened patients had earlier-stage HCC than clinically diagnosed patients, but lead- and length-time biases confounded the effects on mortality.

There were 2 trials that found no survival differences between shorter and longer screening intervals.

The team observed that harms of screening were not well-studied.

Dr Kansagara's team concludes, "There is very-low-strength evidence about the effects of HCC screening on mortality in patients with chronic liver disease."

"Screening tests can identify early-stage HCC, but whether systematic screening leads to a survival advantage over clinical diagnosis is uncertain."

Ann Int Med 2014: 161(4): 261-269
27 August 2014

Go to top of page Email this page Email this page to a colleague

 27 March 2015

Advanced search
 27 March 2015 
Screening for fecal incontinence
 27 March 2015 
Deep remission in Crohn's disease
 27 March 2015 
Sexual functioning in IBD
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 25 March 2015 
Cytomegalovirus and IBD
 24 March 2015 
Prevention of colorectal cancer after screening
 24 March 2015 
Functional GI disorders and body mass index
 24 March 2015 
Quality of life in children with fecal incontinence
 23 March 2015 
Fibrosis in NAFLD vs NASH
 23 March 2015 
The unmasking of Whipple's disease
 23 March 2015 
Predicting the quality of colon cancer care
 20 March 2015 
Interventions for eosinophilic esophagitis
 20 March 2015 
Colorectal cancer risk and genetic variants
 20 March 2015 
Screening for Barrett's esophagus
 19 March 2015 
Hypnotherapy for IBS
 19 March 2015 
Poor mental and physical health in HCV
 19 March 2015 
Dedicated care for diverticular disease
 18 March 2015 
Practice guidelines for colorectal polyps
 18 March 2015 
Out-of-hours endoscopy for upper GI bleeding
 18 March 2015 
H. pylori eradication and lipids
 17 March 2015 
H. pylori test-and-treat program and gastric cancer
 17 March 2015 
Adalimumab in Crohn’s disease
 17 March 2015 

Low-dose PPIs and GI bleeding in patients receiving aspirin

 16 March 2015 
Microscopic colitis
 16 March 2015 
Cholestasis of pregnancy with HCV
 16 March 2015 
Hybrid therapy for H. pylori
 13 March 2015 
Medicare patients and payments to gastroenterologists
 13 March 2015 
Appendectomy in ulcerative colitis
 13 March 2015 

Racial disparities in gluten-sensitive problems

 12 March 2015 
Predicting IBD in IBS patients
 12 March 2015 
Patient knowledge of IBS
 12 March 2015 
Nonceliac gluten sensitivity
 11 March 2015 

Prediction of malignant bile duct obstruction

 11 March 2015 
NAFLD–related hepatocellular carcinoma
 11 March 2015 
Assessment of eosinophilic esophagitis
 10 March 2015 
Risk for gastroesophageal reflux symptoms
 10 March 2015 
Poor disease course in pediatric ulcerative colitis
 10 March 2015 
Outcomes in Crohn's therapy
 09 March 2015 
Fibre usage in ulcerative colitis in remission
 09 March 2015 
Gastric Cancer detection during GI endosocopy
 09 March 2015 
Risk of C. difficile upon hospital admission
 06 March 2015 
Second anti-TNF in IBD
 06 March 2015 
Efficacy of Hep E vaccine
 06 March 2015 
Steroid therapy for eosinophilic esophagitis
 05 March 2015 
EPHXI polymorphism and esophageal cancer risk
 05 March 2015 
Infliximab and immunosuppressant therapy in ulcerative colitis
 05 March 2015 
Neuroendocrine carcinoma of the colon and rectum
 04 March 2015 
Multidisciplinary management of rectal cancer
 04 March 2015 
Management of IBD
 04 March 2015 
Progression of Barrett's
 03 March 2015 
EPHX1 polymorphism and esophageal cancer risk
 03 March 2015 
GI bleeding in chronic kidney disease patients on aspirin
 03 March 2015 
Risk of anastomotic leak after colectomy
 02 March 2015 
Genes and early diagnosis of IBD
 02 March 2015 
Assessment of GERD
 02 March 2015 
Liver disease in patients awaiting liver transplant

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us