Strategies for Increasing Hepatocellular Carcinoma Screening

Percentage of patients with cirrhosis who underwent ultrasound screening for HCC increased with outreach strategies.
Percentage of patients with cirrhosis who underwent ultrasound screening for HCC increased with outreach strategies.

HealthDay News — Outreach strategies increase the percentage of patients with cirrhosis who undergo hepatocellular carcinoma (HCC) screening, according to a study published in Gastroenterology.

Amit G. Singal, MD, from the University of Texas Southwestern Medical Center in Dallas, and colleagues conducted a prospective study of patients with documented or suspected cirrhosis at a safety-net health system. Participants were randomized to groups that received mailed invitations for an ultrasound screening examination, mailed invitations for an ultrasound screening examination and patient navigation (assessment of barriers and motivational education for patients who declined screening), or usual care (600 in each group). Up to three reminder telephone calls were provided for patients who did not respond to outreach invitations within two weeks.

The researchers found that the proportion of patients who underwent HCC screening was greater for those who received the mailed invitation and navigation or received the mailed invitation alone compared with those who received usual care (47.2% and 44.5% vs 24.3%, respectively), in intent-to-treat analysis (P <.001 for both comparisons). There was no significant difference in screening rates between the outreach groups (P =.25). Consistent effects of the outreach program were seen in all subgroups.

"We found outreach strategies to double the percentage of patients with cirrhosis who underwent ultrasound screening for HCC," the authors write. "However, adding patient navigation to telephone reminders provided no significant additional benefit."

One author disclosed financial ties to the pharmaceutical industry.

Reference

Singal AG, Tiro JA, Marrero JA, et al. Mailed outreach program increases ultrasound screening of patients with cirrhosis for hepatocellular carcinoma. Gastroenterology. 2017;152:608-615.e4. doi: 10.1053/j.gastro.2016.10.042

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