Prevention of Hepatocellular Carcinoma
Authors: Hashem B. El-Serag
Journal: Annals of Internal Medicine (2004)

Letters6 July 2004Prevention of Hepatocellular CarcinomaHashem B. El-Serag, MD, MPHHashem B. El-Serag, MD, MPHFrom Houston Veterans Affairs Medical Center, Houston, TX 77030.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-1-200407060-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree that the information Dr. Stark describes should be fully explained to patients and health care providers. However, we believe that current antiviral therapies, because of their relatively low efficacy and effectiveness, are unlikely to cause major changes in the epidemic of HCV-related hepatocellular carcinoma in the near future.Persons likely to have a demonstrable therapy-related reduction in risk for hepatocellular carcinoma are those with advanced fibrosis and cirrhosis. The validity and generalizability of the randomized, controlled trial cited by Dr. Stark (1) are questionable. That study was conducted in Japan, patients were treated with a high ...References1. Nishiguchi S, Kuroki T, Nakatani S, Morimoto H, Takeda T, Nakajima S, et al . Randomised trial of effects of interferon-alpha on incidence of hepatocellular carcinoma in chronic active hepatitis C with cirrhosis. Lancet. 1995;346:1051-5. [PMID: 7564784] CrossrefMedlineGoogle Scholar2. El-Serag HB. Hepatocellular carcinoma and hepatitis C in the United States. Hepatology. 2002;36:S74-83. [PMID: 12407579] MedlineGoogle Scholar3. Seeff LB. Natural history of hepatitis C. Am J Med. 1999;107:10S-15S. [PMID: 10653449] CrossrefMedlineGoogle Scholar4. El-Serag HB, Kunik M, Richardson P, Rabeneck L. Psychiatric disorders among veterans with hepatitis C infection. Gastroenterology. 2002;123:476-82. [PMID: 12145801] CrossrefMedlineGoogle Scholar5. Falck-Ytter Y, Kale H, Mullen KD, Sarbah SA, Sorescu L, McCullough AJ. Surprisingly small effect of antiviral treatment in patients with hepatitis C. Ann Intern Med. 2002;136:288-92. [PMID: 11848726] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Houston Veterans Affairs Medical Center, Houston, TX 77030. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSurprisingly Small Effect of Antiviral Treatment in Patients with Hepatitis C Yngve Falck-Ytter , Hemangi Kale , Kevin D. Mullen , Steedman A. Sarbah , Lucian Sorescu , and Arthur J. McCullough The Continuing Increase in the Incidence of Hepatocellular Carcinoma in the United States: An Update Hashem B. El-Serag , Jessica A. Davila , Nancy J. Petersen , and Katherine A. McGlynn Prevention of Hepatocellular Carcinoma James J. Stark Metrics Cited byPrimary Hepatocellular Carcinoma in an Adolescent Male/An Adult Female 6 July 2004Volume 141, Issue 1Page: 77-78KeywordsAntiviral therapyCirrhosisFibrosisForecastingHealth care providersHepatocellular carcinomaInfectious diseasesRandomized trialsRetrospective studiesRisk management ePublished: 6 July 2004 Issue Published: 6 July 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...