P-22 ANALYSIS OF FEATURES ASSOCIATED WITH DIFFICULTY IN SCREENING AND EARLY DIAGNOSING HEPATOCELLULAR CARCINOMA IN RISK PATIENTS

Several barriers to access hepatocellular carcinoma (HCC) screening in Brazil and the large number of patients diagnosed at advanced disease stages, without prospect of curative treatment, are indicatives that access to early HCC diagnosis and treatment is not equitably guaranteed for entire population. The aim of the current study is to investigate the determining factors hindering the access to HCC screening and early diagnosis, based on abdominal ultrasound (US) application to risk patients. Descriptive and longitudinal study carried out in reference outpatient clinic, based on questionnaire application to patients at risk for HCC. Fifty patients (mean age of 59 years), whose main disease etiology lied on alcohol, and hepatitis B and C viruses, were evaluated; 76% of them underwent US monitoring on a regular basis and 58% understood the importance of undergoing such an examination. The main barriers to access examination comprised scheduling (25%) and financial issues (12.5%). Eight patients were diagnosed with HCC (16% of sample), 50% of them were diagnosed at the first consultation and 37.50% did not know about the importance of such diagnosis (Table); curative treatment was no longer applicable to 62.50% of these patients. It is worth emphasizing the essential role played by half-yearly screening in the early diagnosis and curative treatment of HCC. It is necessary developing policies focused on identifying and placing HCC patients at risk in health surveillance programs, as well as on providing greater access to, and education about the important role played by these exams.