ArticleJournal of the National Comprehensive Cancer Network : JNCCN2015
Diagnostic delays are common among patients with hepatocellular carcinoma.
Article in Journal of the National Comprehensive Cancer Network : JNCCN, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of comparisons of AI and radiologists in the diagnosis of HCC in multiphase CT: implications for practice.Japanese journal of radiology · 2026Pooled it
- Mailed Outreach Invitations Significantly Improve HCC Surveillance Rates in Patients With Cirrhosis: A Randomized Clinical Trial.Hepatology (Baltimore, Md.) · 2019Trial
- Mailed Outreach Program Increases Ultrasound Screening of Patients With Cirrhosis for Hepatocellular Carcinoma.Gastroenterology · 2017Trial
- ΔNp63α‑mediated regulation of tumor‑associated genes and pathways in hepatocellular carcinoma progression.Molecular medicine reports · 2026Article
- RESONANCE: Protocol for a Nationwide Cohort Study of Chronic Liver Diseases Using the French National Health Data System.JMIR research protocols · 2026Article
- Circulating Cell-Free DNA Analysis for Diagnostic and Prognostic Assessment of Hepatocellular Carcinoma in Cirrhosis.International journal of molecular sciences · 2026Article
- Imperatorin: A Furanocoumarin with Potential in Combating Cancer Development and Progression-A Comprehensive Review.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Artificial Intelligence in the Diagnosis and Prognostic Stratification of Hepatocellular Carcinoma: Current Evidence, Clinical Applications, and Future Perspectives.Biomedicines · 2026Review
- Multimodal single-cell network analysis uncovers BSG/CD147 as an early biomarker and signaling hub in hepatocellular carcinoma.Research square · 2026Article
- Care-seeking among hepatocellular carcinoma patients in Uganda: health system navigation and its impact on diagnosis and survival in a prospective case-cohort study.BMJ public health · 2026Article
- Healthcare system complexity of hepatitis B and C related liver disease: service mapping in New South Wales, Australia.Frontiers in health services · 2026Article
- Multimodal Single-Cell Network Analysis Identifies Basigin/Cluster of Differentiation 147 as a Tumor-Associated Signaling Hub in Hepatocellular Carcinoma.Gastro hep advances · 2026Article
- The 'social gradient' in primary liver cancer in France: A national observational study.JHEP reports : innovation in hepatology · 2025Article
- Assessment of Hepatocellular Carcinoma Awareness and Understanding Among Health Science Students: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2025Article
- Wilson's Disease in Oman: A National Cohort Study of Clinical Spectrum, Diagnostic Delay, and Long-Term Outcomes.Clinics and practice · 2025Article
- Emerging vesicular nanosystems capable of effectively targeting hepatocytes.Nanomedicine (London, England) · 2025Review
- Gamma-tocotrienol Inhibits Proliferation and Growth of HSD17B4 Overexpressing HepG2 Liver Cancer Cells.Current cancer drug targets · 2025Article
- Biomarkers for Early Cancer Detection: A Landscape View of Recent Advancements, Spotlighting Pancreatic and Liver Cancers.ACS pharmacology & translational science · 2024Review
- DecipheringEpigenomics · 2024Article
- Liquid Liver Biopsy for Disease Diagnosis and Prognosis.Journal of clinical and translational hepatology · 2023Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundMost patients with hepatocellular carcinoma (HCC) present at advanced stages. The prevalence and clinical impact of delays during diagnostic evaluation among patients with HCC is unclear. PURPOSE: To identify and characterize factors associated with diagnostic delays among patients with HCC.
methodsRecords were reviewed for consecutive patients with cirrhosis and HCC at a large urban hospital between January 2005 and July 2012. Time from presentation to diagnosis was determined using Kaplan-Meier analysis. Diagnostic delay was defined as time to diagnosis exceeding 3 months, and multivariate logistic regression was used to identify correlates of diagnostic delays.
resultsAmong 457 patients with HCC, 226 (49.5%) were diagnosed as outpatients. Among these, median time-to-diagnosis was 2.2 months, with 87 patients (38.5%) experiencing a diagnostic delay. Diagnostic delays were positively associated with the presence of hepatic encephalopathy (odds ratio [OR], 2.29; 95% CI, 1.03-5.07) and negatively associated with presentation after implementation of the electronic medical records (EMR) (OR, 0.28; 95% CI, 0.15-0.52) and presentation with an abnormal ultrasound (OR, 0.36; 95% CI, 0.19-0.67) on multivariate analysis. Higher rates of diagnostic delays were observed among those with hepatic encephalopathy (56% vs 35%), whereas lower rates were seen in those who presented after EMR implementation (26% vs 60%) and those who presented with an abnormal ultrasound with or without an elevated alpha fetoprotein level (27% vs 50%). Among 49 patients with mass-forming HCC and diagnostic delay, 18% had interval tumor growth of 2 cm or greater.
conclusionsNearly 20% of patients with HCC wait more than 3 months from presentation to diagnosis, which can contribute to interval tumor growth.
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