ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2022
Provider Attitudes Toward Risk-Based Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis in the United States.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Synthesising enablers and barriers to hepatocellular carcinoma surveillance-A systematic review of qualitative findings.PloS one · 2025Pooled it
- Hepatocellular carcinoma surveillance may be associated with potential psychological harms in patients with cirrhosis.Hepatology (Baltimore, Md.) · 2024Trial
- Validation of Texas Hepatocellular Carcinoma Consortium Risk Index in the Hepatocellular Carcinoma Early Detection Strategy Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Article
- Pandemic-Related Disruptions and Hepatocellular Carcinoma Surveillance in Safety-Net Settings.JAMA network open · 2026Article
- Development and validation of risk stratification models for hepatocellular cancer: A framework from the translational liver cancer consortium.Hepatology (Baltimore, Md.) · 2026Article
- Risk-stratified surveillance for hepatocellular carcinoma.Hepatology communications · 2026Review
- Refining surveillance of hepatocellular carcinoma in chronic hepatitis B through biomarker-based risk stratification.Hepatology communications · 2026Review
- Research Communication: Serum Metabolomic Signatures Predict Tumour Recurrence After Resection or Ablation in Patients With Early-Stage Hepatocellular Carcinoma.Alimentary pharmacology & therapeutics · 2026Article
- Patient-, Provider-, and Area-Level Factors Associated with Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis in North Carolina.North Carolina medical journal · 2025Article
- Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis at US Safety-Net Health Systems.Clinical and translational gastroenterology · 2025Article
- Patient-Perceived Risk of Hepatocellular Carcinoma and Net Benefit of Surveillance: A Multicenter Survey Study.The American journal of gastroenterology · 2025Article
- Comparative Analysis of Imaging Modalities for Surveillance on Outcomes in Patients With Hepatocellular Carcinoma.Gastro hep advances · 2025Article
- Statewide Survey of Primary Care and Subspecialty Providers on Hepatocellular Carcinoma Risk-Stratification and Surveillance Practices.Digestive diseases and sciences · 2024Article
- Clinician-Level Knowledge and Barriers to Hepatocellular Carcinoma Surveillance.JAMA network open · 2024Article
- Assessing Adherence to US LI-RADS Follow-up Recommendations in Vulnerable Patients Undergoing Hepatocellular Carcinoma Surveillance.Radiology. Imaging cancer · 2024Article
- Health care-related transportation insecurity is associated with adverse health outcomes among adults with chronic liver disease.Hepatology communications · 2024Article
- HCC in peri-transplant period: What a gastroenterologist needs to know.Clinical liver disease · 2023Article
- Precision HCC Surveillance: It Is All in the Number (Needed).Digestive diseases and sciences · 2023Article
- Hepatocellular Carcinoma Risk Scores Predict Patients Under Surveillance at Low Risk of Benefit and High Risk of Harm.Digestive diseases and sciences · 2023Article
- Epidemiology of liver cirrhosis and associated complications: Current knowledge and future directions.World journal of gastroenterology · 2022Review
Corrections and comments
- Commented on byReply.2021
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Authors and funding
33 authors at 20 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsHepatocellular carcinoma (HCC) surveillance rates are suboptimal in clinical practice. We aimed to elicit providers' opinions on the following aspects of HCC surveillance: preferred strategies, barriers and facilitators, and the impact of a patient's HCC risk on the choice of surveillance modality.
methodsWe conducted a web-based survey among gastroenterology and hepatology providers (40% faculty physicians, 21% advanced practice providers, 39% fellow-trainees) from 26 US medical centers in 17 states.
resultsOf 654 eligible providers, 305 (47%) completed the survey. Nearly all (98.4%) of the providers endorsed semi-annual HCC surveillance in patients with cirrhosis, with 84.2% recommending ultrasound ± alpha fetoprotein (AFP) and 15.4% recommending computed tomography (CT) or magnetic resonance imaging (MRI). Barriers to surveillance included limited HCC treatment options, screening test effectiveness to reduce mortality, access to transportation, and high out-of-pocket costs. Facilitators of surveillance included professional society guidelines. Most providers (72.1%) would perform surveillance even if HCC risk was low (≤0.5% per year), while 98.7% would perform surveillance if HCC risk was ≥1% per year. As a patient's HCC risk increased from 1% to 3% to 5% per year, providers reported they would be less likely to order ultrasound ± AFP (83.6% to 68.9% to 57.4%; P < .001) and more likely to order CT or MRI ± AFP (3.9% to 26.2% to 36.1%; P < .001).
conclusionsProviders recommend HCC surveillance even when HCC risk is much lower than the threshold suggested by professional societies. Many appear receptive to risk-based HCC surveillance strategies that depend on patients' estimated HCC risk, instead of our current "one-size-fits all" strategy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.