Screening for Hepatocellular Carcinoma in Chronic Liver Disease
Authors: Edoardo G. Giannini, Franco Trevisani
Journal: Annals of Internal Medicine (2015)

Letters3 February 2015Screening for Hepatocellular Carcinoma in Chronic Liver DiseaseEdoardo G. Giannini, MD, PhD and Franco Trevisani, MDEdoardo G. Giannini, MD, PhDFrom IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, Università di Genova, Genova, Italy, and Università di Bologna—Alma Mater Studiorum, Bologna, Italy. and Franco Trevisani, MDFrom IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, Università di Genova, Genova, Italy, and Università di Bologna—Alma Mater Studiorum, Bologna, Italy.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5049-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Kansagara and colleagues (1) reviewed the literature on HCC surveillance and determine that the evidence supporting the benefits of surveillance is flawed by the retrospective nature of most studies and the confounding effect of lead-time bias. Moreover, they surmise that the possible harms of surveillance have not been adequately assessed and, taking into account the frequent coexistence of cirrhosis, the risk for overdiagnosis may be substantial. They conclude that the benefit of surveillance compared with that of clinical diagnosis of HCC is supported by low-strength evidence.In most patients, HCC ensues in the setting of well-compensated cirrhosis ...References1. Kansagara D, Papak J, Pasha AS, O'Neil M, Freeman M, Relevo R, et al. Screening for hepatocellular carcinoma in chronic liver disease: a systematic review. Ann Intern Med. 2014;161:261-9. [PMID: 24934699] doi:10.7326/M14-0558 LinkGoogle Scholar2. Giannini EG, Cucchetti A, Erroi V, Garuti F, Odaldi F, Trevisani F. Surveillance for early diagnosis of hepatocellular carcinoma: how best to do it? World J Gastroenterol. 2013;19:8808-21. [PMID: 24379604] doi:10.3748/wjg.v19.i47.8808 CrossrefMedlineGoogle Scholar3. Singal AG, Pillai A, Tiro J. Early detection, curative treatment, and survival rates for hepatocellular carcinoma surveillance in patients with cirrhosis: a meta-analysis. PLoS Med. 2014;11:e1001624. [PMID: 24691105] doi:10.1371/journal.pmed.1001624 CrossrefMedlineGoogle Scholar4. Cucchetti A, Trevisani F, Pecorelli A, Erroi V, Farinati F, Ciccarese F, et al; Italian Liver Cancer Group.. Estimation of lead-time bias and its impact on the outcome of surveillance for the early diagnosis of hepatocellular carcinoma. J Hepatol. 2014;61:333-41. [PMID: 24717522] doi:10.1016/j.jhep.2014.03.037 CrossrefMedlineGoogle Scholar5. Poustchi H, Farrell GC, Strasser SI, Lee AU, McCaughan GW, George J. Feasibility of conducting a randomized control trial for liver cancer screening: is a randomized controlled trial for liver cancer screening feasible or still needed? Hepatology. 2011;54:1998-2004. [PMID: 21800340] doi:10.1002/hep.24581 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Edoardo G. Giannini, MD, PhD; Franco Trevisani, MDAffiliations: From IRCCS-Azienda Ospedaliera Universitaria San Martino-IST, Università di Genova, Genova, Italy, and Università di Bologna—Alma Mater Studiorum, Bologna, Italy.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=L14-0524. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Hepatocellular Carcinoma in Chronic Liver Disease Devan Kansagara , Joel Papak , Amirala S. Pasha , Maya O'Neil , Michele Freeman , Rose Relevo , Ana Quiñones , Makalapua Motu'apuaka , and Janice H. Jou Screening for Hepatocellular Carcinoma in Chronic Liver Disease Diana Chirovsky , Kristen Hassmiller Lich , and A. Sidney Barritt IV Screening for Hepatocellular Carcinoma in Chronic Liver Disease Devan Kansagara , Joel Papak , and Janice H. Jou Metrics Cited byThe ITA.LI.CA Consortium: How multicentre collaboration helped shape the management of patients with hepatocellular carcinoma on the basis of real-world evidenceObesity and Hepatocellular Carcinoma: A Complex Relationship 3 February 2015Volume 162, Issue 3 Page: 239-240 Keywords Chronic liver disease Cirrhosis Conflicts of interest Disclosure Hepatocellular carcinoma Liver Retrospective studies ePublished: 3 February 2015 Issue Published: 3 February 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...