Dedicated Automatic Recall Hepatocellular Cancer Surveillance Programme Demonstrates High Retention: A Population‐Based Cohort Study
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Le résumé fourni par la source
INTRODUCTION: Patient, clinician, and system-related barriers may affect adherence to hepatocellular carcinoma (HCC) surveillance programmes. The impact of a dedicated automated recall HCC surveillance programme on retention rates in patients eligible for screening is unknown. We aimed to describe and evaluate a large HCC surveillance programme in a publicly funded healthcare system. METHODS: Data were collected from January 1, 2013, to December 31, 2022, from a retrospective cohort of subjects enrolled in a publicly funded automated recall semi-annual surveillance programme as per the American Association for the Study of Liver Disease HCC guidance in the Calgary Health Zone (~1.6 million), Canada. Patients were excluded if there was incomplete data or did not meet indications for surveillance. Cox regression was used to identify predictors of non-retention to surveillance. RESULTS: A total of 7269 patients were included. The median was age 55.5 years (IQR: 45.5-63.8), 60% were male, 46% were of Asian descent, 51% had HBV infection, and 36% had cirrhosis (35% alcohol-related). Median follow-up was 4.9 years (IQR: 1.5-7.2). Overall, 52% (n = 3768) of patients were retained in the surveillance programme, while 8.3% (n = 603) left for potential medical reasons, and 40% (n = 2898) were lost in follow-up. The median time in the programme for those lost in follow-up was 0.81 years (IQR: 0.0-2.8) compared to 6.75 years if retained (IQR: 5.6-8.6; p < 0.001). In multivariable Cox regression analysis, HCV aetiology (HR 1.41; CI 1.23-1.62, p < 0.01), African ethnicity (HR 1.20, CI 1.02-1.42, p = 0.03), and cirrhosis (HR 1.16, CI 1.05-1.28, p < 0.01) increased risk of dropout. On interaction analysis, Hepatitis B amongst cirrhotic patients also increased risk of dropout (HR 1.48, CI 1.05-2.07, p = 0.02). CONCLUSION: A dedicated automated recall HCC surveillance programme has a high retention rate in a large multi-ethnic cohort of patients while identifying certain marginalised patient populations, such as those with viral liver disease, cirrhosis, or African ethnicity, as particularly vulnerable to loss to follow-up.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Dedicated Automatic Recall Hepatocellular Cancer Surveillance Programme Demonstrates High Retention: A Population‐Based Cohort Study
- Date Crossref
- 10/02/2025
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Western University pays non établi dans la noticeUniversité ou école supérieure
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O'Brien Institute pays non établi dans la noticeStructure de recherche
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Public Health Ontario pays non établi dans la noticeÉtablissement de santé
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University of Calgary pays non établi dans la noticeUniversité ou école supérieure
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Department of Medicine Schulich School of Medicine London Ontario Canada Division of Gastroenterology and Hepatology pays non établi dans la noticeUniversité ou école supérieure
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Department of Oncology Cumming School of Medicine Calgary Alberta Canada Department of Oncology pays non établi dans la noticeUniversité ou école supérieure
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Clinical Research Unit Cumming School of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Department of Radiology Cumming School of Medicine pays non établi dans la noticeUniversité ou école supérieure
Western University, O'Brien Institute et Public Health Ontario, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.