Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study
Abstract Background Hepatocellular carcinoma (HCC) surveillance guidelines recommend ultrasound screening every 6 months, which was determined empirically. Since liver disease progression is heterogeneous among different etiologies, it is clinically valuable to analyze patients with specific etiolog...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-025-14551-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849768622639022080 |
|---|---|
| author | Shen-Shong Chang Yu-Chin Chen Hsiao-Yun Hu Yung-Feng Yen Nicole Huang |
| author_facet | Shen-Shong Chang Yu-Chin Chen Hsiao-Yun Hu Yung-Feng Yen Nicole Huang |
| author_sort | Shen-Shong Chang |
| collection | DOAJ |
| description | Abstract Background Hepatocellular carcinoma (HCC) surveillance guidelines recommend ultrasound screening every 6 months, which was determined empirically. Since liver disease progression is heterogeneous among different etiologies, it is clinically valuable to analyze patients with specific etiologies. The aim of this study was to evaluate the impact of surveillance intervals, duration of cirrhosis, and HCC risk factors on the survival of hepatitis C virus (HCV) cirrhotic patients. Methods This nationwide cohort study included adult patients who were newly diagnosed as having HCV-related cirrhosis between January 2007 and December 2018. 5,093 newly diagnosed cirrhotic HCV related HCC patients were analyzed. The timing of ultrasonography screening was categorized into 4 cohorts: 0- to 6-month cohort (6-month cohort), 7- to 12-month cohort (12-month cohort), 13- to 24-month cohort (24-month cohort), and not screened within 2 years cohort (unscreened cohort). The chance of early stage of HCC diagnosis and receiving curative treatment were calculated. Association between surveillance interval and all-cause mortality was analyzed adjusting for lead-time bias. Results The 6-month group had the highest likelihood of being diagnosed with an early-stage HCC, followed by the 12-month group (OR = 0.69; 95% CI 0.55–0.85) and the 24-month group (OR = 0.355; 95% CI 0.27–0.47), the last by the unscreened group (OR = 0.296; 95% CI 0.22–0.40). The 6-month group had the highest likelihood of being received curative treatment, followed by the 12-month group (OR = 0.721, 95% CI 0.58–0.89) and the 24-month group (OR = 0.584; 95% CI 0.44–0.77), the last by the unscreened group (OR = 0.513; 95% CI 0.38–0.69). The 6-month group had the least likelihood of all-cause mortality, followed by the 12-month group (HR = 1.134; 95% CI 1.02–1.26), the 24-month group (HR = 1.570; 95% CI 1.39–1.77), and the unscreened group (HR = 1.520; 95% CI 1.33–1.73). After adjusting for lead-time bias, the 6-month group had the least likelihood of all-cause mortality. In the 6-month group, cirrhotic HCV patients with an AFP less than 20 ng/ml, with a MELD score less than 20, with cirrhosis duration between 3–5 years had better survival. Conclusion A 6-month surveillance interval can significantly improve the detection rate of early-stage HCC, likelihood of receiving curative treatment, and prolong the overall survival of cirrhotic HCV patients. |
| format | Article |
| id | doaj-art-e541a477a3554b6eb3c8dc65244c52a7 |
| institution | DOAJ |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-e541a477a3554b6eb3c8dc65244c52a72025-08-20T03:03:44ZengBMCBMC Cancer1471-24072025-07-0125111810.1186/s12885-025-14551-9Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort studyShen-Shong Chang0Yu-Chin Chen1Hsiao-Yun Hu2Yung-Feng Yen3Nicole Huang4Division of Gastroenterology, Taipei City Hospital Yang-Ming BranchInstitute of Hospital and Health Care Administration, School of Medicine, National Yang Ming Chiao Tung UniversityInstitute of Public Health, National Yang Ming Chiao Tung UniversityInstitute of Public Health, National Yang Ming Chiao Tung UniversityInstitute of Hospital and Health Care Administration, School of Medicine, National Yang Ming Chiao Tung UniversityAbstract Background Hepatocellular carcinoma (HCC) surveillance guidelines recommend ultrasound screening every 6 months, which was determined empirically. Since liver disease progression is heterogeneous among different etiologies, it is clinically valuable to analyze patients with specific etiologies. The aim of this study was to evaluate the impact of surveillance intervals, duration of cirrhosis, and HCC risk factors on the survival of hepatitis C virus (HCV) cirrhotic patients. Methods This nationwide cohort study included adult patients who were newly diagnosed as having HCV-related cirrhosis between January 2007 and December 2018. 5,093 newly diagnosed cirrhotic HCV related HCC patients were analyzed. The timing of ultrasonography screening was categorized into 4 cohorts: 0- to 6-month cohort (6-month cohort), 7- to 12-month cohort (12-month cohort), 13- to 24-month cohort (24-month cohort), and not screened within 2 years cohort (unscreened cohort). The chance of early stage of HCC diagnosis and receiving curative treatment were calculated. Association between surveillance interval and all-cause mortality was analyzed adjusting for lead-time bias. Results The 6-month group had the highest likelihood of being diagnosed with an early-stage HCC, followed by the 12-month group (OR = 0.69; 95% CI 0.55–0.85) and the 24-month group (OR = 0.355; 95% CI 0.27–0.47), the last by the unscreened group (OR = 0.296; 95% CI 0.22–0.40). The 6-month group had the highest likelihood of being received curative treatment, followed by the 12-month group (OR = 0.721, 95% CI 0.58–0.89) and the 24-month group (OR = 0.584; 95% CI 0.44–0.77), the last by the unscreened group (OR = 0.513; 95% CI 0.38–0.69). The 6-month group had the least likelihood of all-cause mortality, followed by the 12-month group (HR = 1.134; 95% CI 1.02–1.26), the 24-month group (HR = 1.570; 95% CI 1.39–1.77), and the unscreened group (HR = 1.520; 95% CI 1.33–1.73). After adjusting for lead-time bias, the 6-month group had the least likelihood of all-cause mortality. In the 6-month group, cirrhotic HCV patients with an AFP less than 20 ng/ml, with a MELD score less than 20, with cirrhosis duration between 3–5 years had better survival. Conclusion A 6-month surveillance interval can significantly improve the detection rate of early-stage HCC, likelihood of receiving curative treatment, and prolong the overall survival of cirrhotic HCV patients.https://doi.org/10.1186/s12885-025-14551-9Hepatocellular carcinomaSurveillance intervalsCirrhosisHepatitis C virusAFPMELD |
| spellingShingle | Shen-Shong Chang Yu-Chin Chen Hsiao-Yun Hu Yung-Feng Yen Nicole Huang Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study BMC Cancer Hepatocellular carcinoma Surveillance intervals Cirrhosis Hepatitis C virus AFP MELD |
| title | Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study |
| title_full | Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study |
| title_fullStr | Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study |
| title_full_unstemmed | Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study |
| title_short | Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study |
| title_sort | optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis c infection a taiwanese national cohort study |
| topic | Hepatocellular carcinoma Surveillance intervals Cirrhosis Hepatitis C virus AFP MELD |
| url | https://doi.org/10.1186/s12885-025-14551-9 |
| work_keys_str_mv | AT shenshongchang optimalsurveillanceintervalsforhepatocellularcarcinomascreeningincirrhoticpatientswithhepatitiscinfectionataiwanesenationalcohortstudy AT yuchinchen optimalsurveillanceintervalsforhepatocellularcarcinomascreeningincirrhoticpatientswithhepatitiscinfectionataiwanesenationalcohortstudy AT hsiaoyunhu optimalsurveillanceintervalsforhepatocellularcarcinomascreeningincirrhoticpatientswithhepatitiscinfectionataiwanesenationalcohortstudy AT yungfengyen optimalsurveillanceintervalsforhepatocellularcarcinomascreeningincirrhoticpatientswithhepatitiscinfectionataiwanesenationalcohortstudy AT nicolehuang optimalsurveillanceintervalsforhepatocellularcarcinomascreeningincirrhoticpatientswithhepatitiscinfectionataiwanesenationalcohortstudy |