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Cancer Epidemiol. 2014 Dec;38(6):741-7.

Low use of surveillance and early diagnosis of hepatocellular carcinoma in Norway--a population-based cohort study.

Author information

1
Department of Infectious Diseases, Medical Division, Akershus University Hospital, Lørenskog, Norway. arne.eskesen@ahus.no

Abstract

BACKGROUND AND AIMS:

Curative treatment of hepatocellular carcinoma (HCC) is dependent on early diagnosis. Surveillance of patients at high risk for HCC is a key determinant to achieve this goal, but may be an underutilized tool. The aim of this study was to determine the rate of pre-diagnosis surveillance in patients with HCC in a large population-based cohort and to assess to what extent cirrhosis was known prior to the diagnosis of HCC.

METHODS:

All patients diagnosed with HCC during 2000-2009 in The South-Eastern Regional Health Authority, representing 56% of the Norwegian population, were identified from The National Cancer Registry and the medical records were reviewed.

RESULTS:

Fifteen out of 486 patients (3%) were diagnosed by surveillance. Potential curative treatment was offered to 58% of the patients who underwent surveillance as opposed to 15% in the non-surveillance group. Only age ≤ 65 years was an independent predictor of screening in a multivariate model. Almost two thirds of the patients with cirrhosis were unrecognized prior to the HCC diagnosis. Two hundred and fourteen patients (44%) were non-cirrhotics.

CONCLUSION:

Regular HCC surveillance in at-risk populations is virtually not applied in Norway and this may contribute to inferior overall survival. Failure to recognize cirrhosis and a high rate of HCC in non-cirrhotic patients will be limiting factors for the overall effectiveness of a potential surveillance program.

PMID:
25454262
DOI:
10.1016/j.canep.2014.10.005
[Indexed for MEDLINE]

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