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Analysis Finds Scant Evidence to Support Liver Cancer Screening in High-Risk Patients — Physician’s First Watch
Analysis Finds Scant Evidence to Support Liver Cancer Screening in High-Risk Patients
By Amy Orciari Herman
There's little evidence that screening high-risk adults for hepatocellular carcinoma (HCC) improves survival, according to an Annals of Internal Medicine article.
Researchers examined data from 22 studies that assessed the effects of screening (e.g., alpha-fetoprotein testing, ultrasound) on HCC-specific or all-cause mortality among adults with chronic liver disease (with or without cirrhosis).
Overall, they found "very-low-strength evidence from which to draw conclusions about the mortality effects" of screening. For example, only one of two randomized trials showed a mortality benefit with screening versus no screening, and it had "several serious methodological limitations that gave it a high risk of bias." In 18 observational studies, screening generally was associated with earlier-stage HCC, but again, methodological flaws precluded conclusions about any mortality benefit.
The authors, noting that several professional organizations recommend screening, write: "If screening is pursued, it will be important to implement programs in ways that minimize potential harms, especially given the limited empirical evidence of benefit."