ArticleJAMA network open2024
Hepatocellular Carcinoma Screening in a Contemporary Cohort of At-Risk Patients.
Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 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
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- PD-1/PD-L1 Inhibitors Plus Antiangiogenic Drugs Versus Sorafenib as the First Line Treatment for Advanced Hepatocellular Carcinoma: A Phase 3 RCTs Based Meta-Analysis.Technology in cancer research & treatmentPooled it
- Benefits and harms of hepatocellular carcinoma screening outreach in patients with cirrhosis: a multicenter randomized clinical trial.Journal of the National Cancer Institute · 2025Trial
- Hepatobiliary phase imaging in HCC: revisiting diagnostic algorithms and clinical utility of gadoxetic acid-enhanced MRI across international guidelines.Insights into imaging · 2026Review
- Article
- Management and outcomes of patients with liver cancer in China and the United States.Chinese medical journal · 2026Article
- Article
- Very Early-Stage Detection Is Associated With Improved Survival in Patients With Unifocal Hepatocellular Carcinoma.Alimentary pharmacology & therapeutics · 2026Article
- Social Risk Phenotypes Are Strongly Associated With Hepatocellular Carcinoma Outcomes: A Statewide Cohort Study Using Latent Class Analysis.Clinical and translational gastroenterology · 2026Article
- Prognostic Determinants of Disease-Free Survival After Curative Resection for Hepatocellular Carcinoma: A Retrospective Cohort Study.Cancer management and research · 2026Article
- Article
- Hepatocellular Carcinoma Surveillance and Survival in a Contemporary Asia-Pacific Cohort.JAMA network open · 2025Article
- 5-Hydroxymethylcytosine modifications in circulating cell-free DNA: frontiers of cancer detection, monitoring, and prognostic evaluation.Biomarker research · 2025Review
- Persisting challenges in the early detection of hepatocellular carcinoma.Expert review of anticancer therapy · 2025Review
- Hepatocellular carcinoma: updates on epidemiology, surveillance, diagnosis and treatment.Clinical and molecular hepatology · 2025Review
- Statins decrease the risk of hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis.World journal of experimental medicine · 2024Article
- Article
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12 authors.
Funding
Abstract
Importance: Cohort studies demonstrating an association of hepatocellular carcinoma (HCC) screening with reduced mortality are prone to lead-time and length-time biases. Objective: To characterize the clinical benefits of HCC screening, adjusting for lead-time and length-time biases, in a diverse, contemporary cohort of at-risk patients. Design, Setting, and Participants: This retrospective cohort study of patients with HCC was conducted between January 2008 and December 2022 at 2 large US health systems. Data analysis was performed from September to November 2023. Main Outcomes and Measures: The primary outcome was screen-detected HCC, defined by abnormal screening-intent abdominal imaging or α-fetoprotein level within 6 months before diagnosis. Cox regression analysis was used to characterize differences in overall survival between patients with screen-detected and non-screen-detected HCC; lead-time and length-time adjustments were calculated using the Duffy parametric formula. Results: Among 1313 patients with HCC (mean [SD] age, 61.7 [9.6] years; 993 male [75.6%]; 739 [56.3%] with Barcelona Clinic Liver Cancer stage 0/A disease), HCC was screen-detected in 556 (42.3%) and non-screen detected in 757 (57.7%). Patients with screen-detected HCC had higher proportions of early-stage HCC (393 patients [70.7%] vs 346 patients [45.7%]; risk ratio [RR], 1.54; 95% CI, 1.41-1.70) and curative treatment receipt (283 patients [51.1%] vs 252 patients [33.5%]; RR, 1.52; 95% CI, 1.34-1.74) compared with patients with non-screen-detected HCC. The screen-detected group had significantly lower mortality, which persisted after correcting for lead-time bias (hazard ratio, 0.75; 95% CI, 0.65-0.87) in fully adjusted models. Both groups had similar tumor doubling times (median [IQR], 3.8 [2.2-10.7] vs 5.6 [1.7-11.4] months) and proportions of indolent tumors (28 patients [35.4%] vs 24 patients [38.1%]; RR, 0.93; 95% CI, 0.60-1.43). Adjustment for length-time bias decreased survival estimates, although 3-year and 5-year survival for patients with screen-detected HCC remained longer than that for patients with non-screen-detected HCC. Conclusions and Relevance: The findings of this cohort study suggest that HCC screening is associated with reduced mortality even after accounting for lead-time and length-time biases. However, these biases should be considered in future studies.
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