For a study, researchers sought to improve hepatocellular carcinoma (HCC) screening to enable early detection of individuals with cirrhosis caused by hepatitis C (HCV). At Safety-Net hospitals, there was low adherence to HCC screening recommendations. Only 23% of HCC patients in a health system underwent a screening test within a year of diagnosis, and 46% had stage IV disease. The majority (75%) of the patients’ HCCs were still caused by HCV-induced cirrhosis. An HCC screening quality improvement project was started for patients with transient elastography and stage 3 fibrosis or cirrhosis in an established HCV treatment center. Semi-annual imaging was the program’s main component. Navigators tracked compliance and organized appointments for imaging. About 318 patients (mean age 61 years, 81% Black race, 38% uninsured) were enrolled between April 2018 and April 2021. The number of patients who completed their first, second, and third imaging examinations was greater than previously reported (94%, 75%, and 74%, respectively). Around 22 individuals (7%), with 55% stage I and 14% stage IV HCC, received the diagnosis. Total of 13 (59%) of the total patients who were referred received care. It took 77 days on average to receive treatment (range 32–282). Patients who received treatment had a 32-month median overall survival. In the study, the earlier diagnosis was made possible by implementing an HCC screening program at a safety-net hospital. The program’s success was largely attributed to patient navigation and imaging test completion tracking. The initiative will next be expanded to include more at-risk groups.

 

Source: journals.lww.com/annalsofsurgery/Abstract/2022/09000/Implementation_of_a_Hepatocellular_Carcinoma.15.aspx