Evidence map›Paper›PMID 36726052›Full record

ArticleClinical and molecular hepatology2023

Factors associated with unrecognized cirrhosis in patients with hepatocellular carcinoma.

Yi-Te Lee, Mohammad A Karim, Hye Chung Kum, Sulki Park, Nicole E Rich, Mazen Noureddin, Amit G Singal, Ju Dong Yang

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and molecular hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Disentangling the Effect of BMI on Hepatocellular Carcinoma From Cirrhosis With Multivariable Mendelian Randomization.Liver international : official journal of the International Association for the Study of the Liver · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Yi-Te LeeCalifornia NanoSystems Institute, Crump Institute for Molecular Imaging, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA, USA.
Mohammad A KarimPopulation Informatics Lab, School of Public Health, Texas A&M University, College Station, TX, USA.
Hye Chung KumPopulation Informatics Lab, School of Public Health, Texas A&M University, College Station, TX, USA.
Sulki ParkPopulation Informatics Lab, School of Public Health, Texas A&M University, College Station, TX, USA.
Nicole E RichDivision of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Mazen NoureddinKarsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Amit G SingalDivision of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Ju Dong YangKarsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Texas A&M University · USCedars-Sinai Medical Center · USThe University of Texas Southwestern Medical Center · USCalifornia NanoSystems Institute · US

Funding

Multilevel factors for racial/ethnic and socioeconomic disparities in prognosis of hepatocellular carcinomaR01MD012565 · NIMHD · UT SOUTHWESTERN MEDICAL CENTER · PI SINGAL, AMIT, YOPP, ADAM · 2018 to 2022
$4.3M
Precision Risk Stratification and Screening for HCC among Patients with Cirrhosis in the United StatesU01CA230694 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI SINGAL, AMIT · 2018 to 2022
$3.5M
Novel circulating biomarker digital scores for assessing treatment response in liver cancerK08CA259534 · NCI · CEDARS-SINAI MEDICAL CENTER · PI YANG, JU DONG · 2022 to 2024
$807k
NCI NIH HHS K08 CA259534NCI NIH HHS U01 CA230694NIH HHS K08 CA259534NIH HHS R01 MD012565NIH HHS U01 CA230694NIMHD NIH HHS R01 MD012565
6 · The paper itself

Abstract

BACKGROUND/

aimsCirrhosis is the most important risk factor of hepatocellular carcinoma (HCC), and patients with cirrhosis are recommended to receive semiannual surveillance for early HCC detection. However, early cirrhosis is often asymptomatic and can go undiagnosed for years, leading to underuse of HCC surveillance in clinical practice. We characterized the frequency and associated factors of unrecognized cirrhosis in a national sample of patients with HCC from the United States.

methodsHCC patients aged 68 years and older, diagnosed during 2011 to 2015 were included from the SEERMedicare Linked Database. If cirrhosis was diagnosed within 6 months immediately preceding HCC diagnosis or after HCC diagnosis, cases were categorized as unrecognized cirrhosis. Factors associated with unrecognized cirrhosis were identified using logistic regression analyses. Factors associated with overall survival were evaluated using Cox regression analyses.

resultsAmong 5,098 HCC patients, 74.8% patients had cirrhosis. Among those with cirrhosis, 57.4% had unrecognized cirrhosis, with the highest proportion (76.3%) among those with NAFLD-related HCC. Male sex (aOR: 2.12, 95% CI: 1.83-2.46), non-Hispanic Black race (aOR: 1.93, 95% CI: 1.45-2.57), and NAFLD etiology (aOR: 4.46, 95% CI: 3.68-5.41) were associated with having unrecognized cirrhosis. Among NAFLD-related HCC patients, male sex (aOR: 2.32, 95% CI: 1.71-3.14) was associated with unrecognized cirrhosis. Unrecognized cirrhosis was independently associated with worse overall survival (aHR: 1.17, 95% CI: 1.08-1.27) compared to recognized cirrhosis.

conclusionUnrecognized cirrhosis is common in NAFLD-related HCC, particularly among male and Black patients, highlighting these groups as important intervention targets to improve HCC surveillance uptake and outcomes.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsNon-alcoholic Fatty Liver DiseaseFibrosisHumansLiver CirrhosisMaleRisk FactorsCancer screeningHepatocellular carcinomaLiver cirrhosisNAFLD

Identifiers

PMID36726052
PMCPMC10121289
OpenAlexW4318922249

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.