The DOI matches its Crossref record; 55 of the 56 references it cites were found in a registry or an index.
Use of hepatocellular carcinoma surveillance in patients with cirrhosis: a systematic review and meta-analysis
Open accessAbstract
BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) surveillance is associated with early tumor detection and improved survival; however, it is often underused in clinical practice. We aimed to characterize surveillance use among patients with cirrhosis and the efficacy of interventions to increase surveillance. APPROACH AND RESULTS: We performed a systematic literature review using the MEDLINE database from January 2010 through August 2018 to identify cohort studies evaluating HCC surveillance receipt or interventions to increase surveillance in patients with cirrhosis. A pooled estimate for surveillance receipt with 95% confidence intervals was calculated. Correlates of surveillance use were defined from each study and prespecified subgroup analyses. Twenty-nine studies, with a total of 118,799 patients, met inclusion criteria, with a pooled estimate for surveillance use of 24.0% (95% confidence interval, 18.4-30.1). In subgroup analyses, the highest surveillance receipt was reported in studies with patients enrolled from subspecialty gastroenterology/hepatology clinics and lowest in studies characterizing surveillance in population-based cohorts (73.7% versus 8.8%, P < 0.001). Commonly reported correlates of surveillance included higher receipt among patients followed by subspecialists and lower receipt among those with alcohol-associated or nonalcoholic steatohepatitis (NASH)-related cirrhosis. All eight studies (n = 5,229) evaluating interventions including patient/provider education, inreach (e.g., reminder and recall systems), and population health outreach strategies reported significant increases (range 9.4%-63.6%) in surveillance receipt. CONCLUSIONS: HCC surveillance remains underused in clinical practice, particularly among patients with alcohol-associated or NASH-related cirrhosis and those not followed in subspecialty gastroenterology clinics. Interventions such as provider education, inreach including reminder systems, and population health outreach efforts can significantly increase HCC surveillance.
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“Cirrhosis in MASLD is under-recognised compared to other aetiologies, 248 with less than one in four individuals with cirrhosis undergoing HCC surveillance. 249”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [249]
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Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21492 · Cited by 84,109
EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
Galle, P. R., Forner, A., Llovet, J. M., Mazzaferro, V., Piscaglia, F., Raoul, J.-L., Schirmacher, P., & Vilgrain, V. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.03.019 · Cited by 11,406
Rahib, L., Smith, B. D., Aizenberg, R., Rosenzweig, A. B., Fleshman, J. M., & Matrisian, L. M. (2014) · Cancer Research · doi:10.1158/0008-5472.can-14-0155 · Cited by 7,094
AASLD guidelines for the treatment of hepatocellular carcinoma
Heimbach, J. K., Kulik, L., Finn, R. S., Sirlin, C. B., Abecassis, M. M., Roberts, L. R., Zhu, A. X., Murad, M. H., & Marrero, J. A. (2017) · Hepatology · doi:10.1002/hep.29086 · Cited by 4,107
Self-citationEl-Serag, H. B. (2011) · New England Journal of Medicine · doi:10.1056/nejmra1001683 · Cited by 3,529
Singal, A. G., Pillai, A., & Tiro, J. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001624 · Cited by 817
Self-citationCancer Screening Test Use — United States, 2015
White, A. L., Thompson, T., White, M. C., Sabatino, S. A., de Moor, J. S., Doria-Rose, V. P., Geiger, A. M., & Richardson, L. C. (2017) · MMWR Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm6608a1 · Cited by 602
Benvegnù, L., Gios, M., Boccato, S., & Alberti, A. (2004) · Gut · doi:10.1136/gut.2003.020263 · Cited by 452
Use of Surveillance for Hepatocellular Carcinoma Among Patients With Cirrhosis in the United States
Davila, J. A., Morgan, R. O., Richardson, P., Du, X. L., McGlynn, K. A., & El‐Serag, H. B. (2010) · Hepatology · doi:10.1002/hep.23615 · Cited by 392
Population-based risk factors and resource utilization for HCC: US perspective
Sanyal, A. J., Poklepovic, A. S., Moyneur, É., & Barghout, V. E. (2010) · Current Medical Research and Opinion · doi:10.1185/03007995.2010.506375 · Cited by 312
Research works printed but not linked: 1
- 2018, Medical monitoring among cirrhotic patients in real world practice: a nationwide US study with 43,915 cirrhotics, Hepatology
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Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210
AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma
Singal, A. G., Llovet, J. M., Yarchoan, M., Mehta, N., Heimbach, J. K., Dawson, L. A., Jou, J. H., Kulik, L. M., Agopian, V. G., Marrero, J. A., et al. (2023) · Hepatology · doi:10.1097/hep.0000000000000466 · Cited by 2,052
“[91,94,95] The AASLD recommends use of these evidence-based interventions to increase surveillance utilization in clinical practice.”
Self-citationSingal, A. G., Kanwal, F., & Llovet, J. M. (2023) · Nature Reviews Clinical Oncology · doi:10.1038/s41571-023-00825-3 · Cited by 1,029
Self-citation(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 545
Ganesan, P., & Kulik, L. (2022) · Clinics in Liver Disease · doi:10.1016/j.cld.2022.08.004 · Cited by 489
Metadata
- Authors
- Wolf, E., Rich, N. E., Marrero, J. A., Parikh, N. D., & Singal, A. G.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- University of Michigan (US)
- Corresponding author
- Singal, Amit G.
- Venue
- Hepatology
- Published
- 2020-11-20
- Volume
- 73
- Issue
- 2
- Pages
- 713-725
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- PMC
- PMC7648722
- OpenAlex
- W3021721319
- Cited by
- 333
- References
- 56
- Citations by year
- 2026: 47 · 2025: 69 · 2024: 66 · 2023: 57 · 2022: 48 · 2021: 33 · 2020: 13
- FWCI
- 5.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (U01CA230694, U01CA230669)
- Topics
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Keywords
- HCC surveillance, liver cirrhosis, alcoholic cirrhosis, nonalcoholic steatohepatitis, provider education, early cancer detection
- MeSH terms
- Carcinoma, Hepatocellular, Humans, Liver Cirrhosis, Liver Neoplasms, Mass Screening, Patient Acceptance of Health Care, Practice Patterns, Physicians', Guideline Adherence, Early Detection of Cancer
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