Screening for Hepatocellular Carcinoma in Chronic Liver Disease
Authors: Devan Kansagara, Joel Papak, Janice H. Jou
Journal: Annals of Internal Medicine (2015)

Letters3 February 2015Screening for Hepatocellular Carcinoma in Chronic Liver DiseaseDevan Kansagara, MD, MCR, Joel Papak, MD, and Janice H. Jou, MD, MHSDevan Kansagara, MD, MCRFrom Veterans Affairs Medical Center, Portland, Oregon.Search for more papers by this author, Joel Papak, MDFrom Veterans Affairs Medical Center, Portland, Oregon.Search for more papers by this author, and Janice H. Jou, MD, MHSFrom Veterans Affairs Medical Center, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5049-3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Chirovsky and colleagues that modeling and simulation data are potentially useful but did not find ample natural history data that could be used as a foundation for such models. We discovered little data about the natural history of screen-detected cancer, which can differ substantially from that of clinically detected cancer. As we note, several older studies suggest a broad range of natural history for HCC.We found several observational studies that attempted to adjust for lead time and discovered that observed differences in survival could be attributed to lead-time bias when longer tumor-doubling time ...References1. Kansagara D, Papak J, Pasha AS, O'Neil M, Freeman M, Relevo R, Quinones A, Motu'apuaka M, Jou JH. Screening for hepatocellular cancer in chronic liver disease: a systematic review. VA-ESP project no. 05-225. (Prepared by Evidence-based Synthesis Program Center). 2013. Google Scholar2. Wang JH, Chang KC, Kee KM, Chen PF, Yen YH, Tseng PL, et al. Hepatocellular carcinoma surveillance at 4- vs. 12-month intervals for patients with chronic viral hepatitis: a randomized study in community. Am J Gastroenterol. 2013;108:416-24. [PMID: 23318478] doi:10.1038/ajg.2012.445 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Devan Kansagara, MD, MCR; Joel Papak, MD; Janice H. Jou, MD, MHSAffiliations: From Veterans Affairs Medical Center, Portland, Oregon.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOf InterestForms.do?msNum=M14-0558. 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 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 Edoardo G. Giannini and Franco Trevisani 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 Edoardo G. Giannini and Franco Trevisani Metrics Cited byEffect of travel distance and rurality of residence on initial surveillance for hepatocellular carcinoma in VA primary care patient with cirrhosisUp-regulation of miR-95-3p in hepatocellular carcinoma promotes tumorigenesis by targeting p21 expression 3 February 2015Volume 162, Issue 3Page: 240KeywordsCancer screeningCancer treatmentChronic liver diseaseConflicts of interestDisclosureHepatocellular carcinomaObservational studiesPatientsScreening guidelines ePublished: 3 February 2015 Issue Published: 3 February 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...