See Editorial on Page 1673
Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan
Article first published online: 1 APR 2014
Copyright © 2014 The Authors. HEPATOLOGY published by Wiley on behalf of the American Association for the Study of Liver Diseases.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Volume 59, Issue 5, pages 1840–1849, May 2014
How to Cite
Yeh, Y.-P., Hu, T.-H., Cho, P.-Y., Chen, H.-H., Yen, A. M.-F., Chen, S. L.-S., Chiu, S. Y.-H., Fann, J. C.-Y., Su, W.-W., Fang, Y.-J., Chen, S.-T., San, H.-C., Chen, H.-P., Liao, C.-S. and Changhua Community-Based Abdominal Ultrasonography Screening Group (2014), Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan. Hepatology, 59: 1840–1849. doi: 10.1002/hep.26703
Potential conflict of interest: Nothing to report.
- Issue published online: 23 APR 2014
- Article first published online: 1 APR 2014
- Accepted manuscript online: 26 AUG 2013 09:42AM EST
- Manuscript Accepted: 18 AUG 2013
- Manuscript Received: 20 DEC 2012
Mass screening with abdominal ultrasonography (AUS) has been suggested as a tool to control adult hepatocellular carcinoma (HCC) in individuals, but its efficacy in reducing HCC mortality has never been demonstrated. This study aimed to assess the effectiveness of reducing HCC mortality by mass AUS screening for HCC based on a program designed and implemented in the Changhua Community-based Integrated Screening (CHCIS) program with an efficient invitation scheme guided by the risk score. We invited 11,114 (27.0%) of 41,219 eligible Taiwanese subjects between 45 and 69 years of age who resided in an HCC high-incidence area to attend a risk score-guided mass AUS screening between 2008 and 2010. The efficacy of reducing HCC mortality was estimated. Of the 8,962 AUS screening attendees (with an 80.6% attendance rate), a total of 16 confirmed HCC cases were identified through community-based ultrasonography screening. Among the 16 screen-detected HCC cases, only two died from HCC, indicating a favorable survival. The cumulative mortality due to HCC (per 100,000) was considerably lower in the invited AUS group (17.26) compared with the uninvited AUS group (42.87) and the historical control group (47.51), yielding age- and gender-adjusted relative mortality rates of 0.69 (95% confidence interval [CI]: 0.56-0.84) and 0.63 (95% CI: 0.52-0.77), respectively. Conclusion: The residents invited to community-based AUS screening for HCC, compared with those who were not invited, showed a reduction in HCC mortality by ∼31% among subjects aged 45-69 years who had not been included in the nationwide vaccination program against hepatitis B virus infection. (Hepatology 2014;59:1840–1849)