Liver cancer
screening for people with hepatitis B virus (HBV) infection should be
targeted at those with cirrhosis, according to the results of a systematic
review and meta-analysis published in PLOS
ONE. The risk of hepatocellular carcinoma (HCC) and death were 31-
and 44-
times higher, respectively, in people with liver cirrhosis compared to
people who did not have cirrhosis. Moreover, incidence among people
without cirrhosis
was well below the threshold of screening cost effectiveness.
“Cost of screening
HBV patients without cirrhosis may outweigh the benefits,” comment the authors.
“Additionally, it is important to balance potential benefits with potential
harms of screening.”
“The combined
evidence stresses the importance of risk stratification in HBV,” conclude the
authors. “In non-cirrhotic patients without inflammatory activity HCC screening
could be futile due to the low incidence, whereas efforts should be made to
detect HCC in at-risk patients with cirrhosis, HCV coinfection, old age and
inflammatory activity.”
Read more...Labels: cirrhosis, disease progression, Liver cancer HCC, screening