Performance and effectiveness of hepatocellular carcinoma screening in individuals with HBsAg seropositivity in China: a multicenter prospective study
Current guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, including individuals with hepatitis B virus infection. However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese po...
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| Veröffentlicht in: | Nature cancer 2023-09, Vol.4 (9), p.1382-1394 |
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| creator | Zeng, Hongmei Cao, Maomao Xia, Changfa Wang, Dongmei Chen, Kun Zhu, Zheng Fu, Ruiying Zhang, Shaokai Zhou, Jinyi Wang, Huadong Qi, Xianyun Dai, Shuguang Chen, Yong Sun, Zhong Ding, Hao Li, Qingwen Zhao, Hui Zhang, Xuehong Morze, Jakub Ji, John S Sun, Feng Yu, Xueqin Qu, Chunfeng Chen, Wanqing |
| description | Current guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, including individuals with hepatitis B virus infection. However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese population. Between 2017 and 2021, we included 14,426 participants with hepatitis B surface antigen seropositivity in an annual HCC screening study in China using a multicenter prospective design with ultrasonography and serum alpha-fetoprotein. After four rounds of screening and follow-up, the adjusted hazard ratios of death after correction for lead-time and length-time biases for screen-detected cancers at the prevalent and incident rounds were 0.74 (95% confidence interval = 0.60-0.91) and 0.52 (95% confidence interval = 0.40-0.68), respectively. A meta-analysis demonstrated that HCC screening was associated with improved survival after adjusting for lead-time bias. Our findings highlight the 'real-world' feasibility and effectiveness of annual HCC screening in community settings for the early detection of HCC and to improve survival. |
| doi_str_mv | 10.1038/s43018-023-00618-8 |
| format | Article |
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However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese population. Between 2017 and 2021, we included 14,426 participants with hepatitis B surface antigen seropositivity in an annual HCC screening study in China using a multicenter prospective design with ultrasonography and serum alpha-fetoprotein. After four rounds of screening and follow-up, the adjusted hazard ratios of death after correction for lead-time and length-time biases for screen-detected cancers at the prevalent and incident rounds were 0.74 (95% confidence interval = 0.60-0.91) and 0.52 (95% confidence interval = 0.40-0.68), respectively. A meta-analysis demonstrated that HCC screening was associated with improved survival after adjusting for lead-time bias. Our findings highlight the 'real-world' feasibility and effectiveness of annual HCC screening in community settings for the early detection of HCC and to improve survival.</description><identifier>ISSN: 2662-1347</identifier><identifier>EISSN: 2662-1347</identifier><identifier>DOI: 10.1038/s43018-023-00618-8</identifier><identifier>PMID: 37667043</identifier><language>eng</language><publisher>England</publisher><subject>Carcinoma, Hepatocellular - diagnosis ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - virology ; China - epidemiology ; Hepatitis B - blood ; Hepatitis B - complications ; Hepatitis B Surface Antigens - blood ; Humans ; Liver Neoplasms - diagnosis ; Liver Neoplasms - epidemiology ; Liver Neoplasms - virology ; Prospective Studies</subject><ispartof>Nature cancer, 2023-09, Vol.4 (9), p.1382-1394</ispartof><rights>2023. 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However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese population. Between 2017 and 2021, we included 14,426 participants with hepatitis B surface antigen seropositivity in an annual HCC screening study in China using a multicenter prospective design with ultrasonography and serum alpha-fetoprotein. After four rounds of screening and follow-up, the adjusted hazard ratios of death after correction for lead-time and length-time biases for screen-detected cancers at the prevalent and incident rounds were 0.74 (95% confidence interval = 0.60-0.91) and 0.52 (95% confidence interval = 0.40-0.68), respectively. A meta-analysis demonstrated that HCC screening was associated with improved survival after adjusting for lead-time bias. 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| subjects | Carcinoma, Hepatocellular - diagnosis Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - virology China - epidemiology Hepatitis B - blood Hepatitis B - complications Hepatitis B Surface Antigens - blood Humans Liver Neoplasms - diagnosis Liver Neoplasms - epidemiology Liver Neoplasms - virology Prospective Studies |
| title | Performance and effectiveness of hepatocellular carcinoma screening in individuals with HBsAg seropositivity in China: a multicenter prospective study |
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