Financial Burden of Hepatocellular Carcinoma Screening in Patients with Cirrhosis

Letter Gastroenterology & Hepatology

Risk of Hepatocellular Carcinoma in Patients With Indeterminate (LI-RADS 3) Liver Observations

Ashwini Arvind et al.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2023)

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Editorial Material Gastroenterology & Hepatology

Racial and Ethnic Disparities in Barriers to Care in Patients with Hepatocellular Carcinoma

Haley Schoenberger et al.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2023)

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Editorial Material Gastroenterology & Hepatology

Clinical Outcomes of Patients With Suspicious (LI-RADS 4) Liver Observations

Kristeen Onyirioha et al.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2023)

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Article Radiology, Nuclear Medicine & Medical Imaging

Multicenter Validation of Abbreviated MRI for Detecting Early-Stage Hepatocellular Carcinoma

Takeshi Yokoo et al.

Summary: This study evaluated the sensitivity and specificity of dynamic contrast-enhanced abbreviated MRI for the detection of early-stage hepatocellular carcinoma (HCC). The results showed that dynamic abbreviated MRI had high sensitivity and specificity in detecting early-stage HCC in patients with compensated cirrhosis, but lower sensitivity in those with decompensated cirrhosis.

RADIOLOGY (2023)

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Editorial Material Gastroenterology & Hepatology

Precision HCC Surveillance: It Is All in the Number (Needed)

Amit G. Singal et al.

DIGESTIVE DISEASES AND SCIENCES (2023)

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Article Gastroenterology & Hepatology

AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma

Amit G. Singal et al.

HEPATOLOGY (2023)

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Review Gastroenterology & Hepatology

Blood-based biomarkers for hepatocellular carcinoma screening: Approaching the end of the ultrasound era?

Neehar D. Parikh et al.

Summary: Hepatocellular carcinoma (HCC) is a major contributor to cancer-related deaths globally due to inadequate early detection strategies. Current screening recommendations have several deficiencies, including suboptimal sensitivity and poor adherence. Blood-based biomarkers show promise but require validation and logistical solutions before clinical implementation. Maturing validation cohorts, such as the Hepatocellular Carcinoma Early Detection Study and the Texas Hepatocellular Carcinoma Consortium, are expected to provide robust validation for candidate biomarkers.

JOURNAL OF HEPATOLOGY (2023)

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Article Gastroenterology & Hepatology

Healthcare Costs for Medicare Patients With Hepatocellular Carcinoma in the United States

Mohammad A. Karim et al.

Summary: This study aimed to assess the financial burden of hepatocellular carcinoma (HCC) in the United States. Through analyzing a cohort of 4525 adult patients diagnosed with HCC between 2011 and 2015, it was found that HCC patients had significantly higher healthcare costs and patient liabilities in the first year after diagnosis. Additionally, early-stage HCC patients had lower incremental costs compared to those with larger tumor burden.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2023)

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Article Gastroenterology & Hepatology

Recall patterns and risk of primary liver cancer for subcentimeter ultrasound liver observations: a multicenter study

Amit G. Singal et al.

Summary: There is a wide variation in recall patterns for patients with subcentimeter liver lesions on ultrasound. The low risk of primary liver cancer (PLC) in these patients supports short-interval ultrasound follow-up in 3-6 months, but high-risk subgroups may require diagnostic CT/MRI.

HEPATOLOGY COMMUNICATIONS (2023)

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Article Gastroenterology & Hepatology

Depression and Anxiety Are Common Among Patients With Cirrhosis

Ruben Hernaez et al.

Summary: This study examined the prevalence and risk factors for depression and anxiety among patients with cirrhosis in the United States. It found that nearly 1 in 6 patients with cirrhosis have moderately severe to severe depression and nearly half have moderate-severe anxiety. Self-reported poor health was identified as a significant risk factor for both depression and anxiety.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Review Gastroenterology & Hepatology

Conceptual Model for the Hepatocellular Carcinoma Screening Continuum: Current Status and Research Agenda

Amit G. Singal et al.

Summary: Hepatocellular carcinoma (HCC) has a poor prognosis with survival rates below 20% in 5 years, partly due to failures in the cancer screening process continuum. A conceptual model outlining discrete steps in the HCC screening process highlights delays or failures at each step and identifies factors contributing to these failures at the patient, provider, and health care system levels. Comparing HCC screening processes with breast and colorectal cancer screening can help identify opportunities for improvement and ultimately improve early detection of HCC.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Article Radiology, Nuclear Medicine & Medical Imaging

Associations of Ultrasound LI-RADS Visualization Score With Examination, Sonographer, and Radiologist Factors: Retrospective Assessment in Over 10,000 Examinations

David T. Fetzer et al.

Summary: This study identified patient location and sonographer volume as important factors influencing the visualization score of liver ultrasound in HCC screening, which is significant for guiding targeted quality improvement efforts and establishing best practices and performance standards for screening programs.

AMERICAN JOURNAL OF ROENTGENOLOGY (2022)

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Article Gastroenterology & Hepatology

Multicenter Randomized Clinical Trial of a Mailed Outreach Strategy for Hepatocellular Carcinoma Surveillance

Amit G. Singal et al.

Summary: Mailed outreach for HCC surveillance significantly increased semiannual surveillance and improved proportion of time covered by surveillance in patients with cirrhosis. The intervention effect was consistent across most examined subgroups. Continued follow-up is needed to assess the impact on downstream outcomes.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Article Gastroenterology & Hepatology

HCC surveillance improves early detection, curative treatment receipt, and survival in patients with cirrhosis: A meta-analysis

Amit G. Singal et al.

Summary: In this systematic review and meta-analysis, HCC surveillance was found to be associated with improved early-stage detection, curative treatment receipt, and survival in patients with cirrhosis. However, there was significant heterogeneity in the pooled estimates, and there were fewer data quantifying potential surveillance-related harms. Available data suggest that HCC surveillance is of high value in patients with cirrhosis, although further studies evaluating benefits and harms are still needed.

JOURNAL OF HEPATOLOGY (2022)

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Article Gastroenterology & Hepatology

Patient Preferences for Hepatocellular Carcinoma Surveillance Parameters

Sean A. Woolen et al.

Summary: This study assessed patients with cirrhosis' preferences for HCC surveillance modalities, finding that patients prioritize benefits of surveillance over potential harms or inconveniences. Patients showed a preference for abbreviated MRI, MRI, or blood-based biomarkers over traditional ultrasound or ultrasound with AFP.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Review Gastroenterology & Hepatology

Financial burden in adults with chronic liver disease: A scoping review

Nneka N. Ufere et al.

Summary: The economic burden of chronic liver disease is rising, and this study explored the financial impact on patients and families. It found high rates of financial burden and distress among patients with chronic liver disease and their caregivers, which were associated with poor health outcomes. The study emphasizes the need for interventions to mitigate financial burden and distress in chronic liver disease care.

LIVER TRANSPLANTATION (2022)

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Editorial Material Oncology

Financial Toxicity of Cancer Treatment

M. Qasim Hussaini et al.

JAMA ONCOLOGY (2022)

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Article Medicine, General & Internal

Gaps in hepatocellular carcinoma surveillance in a United States cohort of insured patients with cirrhosis

Mindie H. Nguyen et al.

Summary: Objective surveillance for hepatocellular carcinoma (HCC) is underutilized, especially among patients with nonviral etiologies and those who have not seen a gastroenterologist. Surveillance-related costs and lost productivity are substantial. Developing surveillance strategies that reduce patient burden can improve surveillance adherence and effectiveness.

CURRENT MEDICAL RESEARCH AND OPINION (2022)

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Review Gastroenterology & Hepatology

Clinical outcomes of patients with Liver Imaging Reporting and Data System 3 or Liver Imaging Reporting and Data System 4 observations in patients with cirrhosis: A systematic review

Mounika Kanneganti et al.

Summary: This article systematically reviewed cohort studies examining the incidence of HCC among patients with LR-3 or LR-4 observations on CT or MRI, and summarized the range of HCC occurrence and related factors. The study suggests that higher quality studies are necessary to identify high-risk patients who require close CT or MRI-based follow-up.

LIVER TRANSPLANTATION (2022)

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Article Gastroenterology & Hepatology

Patient-Reported Barriers Are Associated With Receipt of Hepatocellular Carcinoma Surveillance in a Multicenter Cohort of Patients With Cirrhosis

Amit G. Singal et al.

Summary: The study found that patient-reported barriers such as knowledge deficits, costs, difficulty scheduling, and transportation significantly impact less frequent receipt of HCC surveillance. This indicates a need for patient-centered interventions, such as patient navigation.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Article Gastroenterology & Hepatology

Benefits and Harms of Hepatocellular Carcinoma Surveillance in a Prospective Cohort of Patients With Cirrhosis

Amit G. Singal et al.

Summary: In a cohort of patients with cirrhosis, HCC surveillance was associated with high early tumor detection and minimal physical harms.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Editorial Material Oncology

Time to add screening for financial hardship as a quality measure?

Cathy J. Bradley et al.

Summary: Cancer treatment is causing financial hardships for many patients and families, with discussions about the cost of treatment being infrequent in clinical practices. Implementing financial hardship screening and management as a quality metric for oncology practices is proposed to address the rising costs and disparities in ability to pay. Successful introduction of quality measurement and reporting in cancer care has improved standards of care and reduced disparities in care delivery.

CA-A CANCER JOURNAL FOR CLINICIANS (2021)

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Review Gastroenterology & Hepatology

Abbreviated MRI for hepatocellular carcinoma screening: A systematic review and meta-analysis

Pankaj Gupta et al.

Summary: Abbreviated MRI (AMRI) is suggested as an alternative for hepatocellular carcinoma (HCC) screening. Our study showed that AMRI has high sensitivity and specificity for HCC screening. Different AMRI protocols have comparable diagnostic performance.

JOURNAL OF HEPATOLOGY (2021)

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Article Oncology

Improving the Process of Screening for Medical Financial Hardship in Oncology Practice

K. Robin Yabroff et al.

Summary: As medical financial hardship becomes more common among cancer patients and survivors, there is a pressing need to identify and mitigate financial difficulties through comprehensive screening and support services. Strategies to address disparities in screening practices and ensure equal access to quality cancer treatment are crucial.

CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION (2021)

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Article Oncology

Diagnostic and Therapeutic Delays in Patients With Hepatocellular Carcinoma

Ashwin Rao et al.

Summary: Delays in diagnosis and treatment are common in patients with HCC, but treatment delays do not seem to significantly impact overall survival.

JOURNAL OF THE NATIONAL COMPREHENSIVE CANCER NETWORK (2021)

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Article Oncology