Cirrhosis is under-recognised in patients subsequently diagnosed with hepatocellular cancer

Alimentary Pharmacology & Therapeutics
M WalkerFasiha Kanwal

Abstract

Most clinical practice guidelines recommend screening for HCC in patients with cirrhosis. However, patients with compensated cirrhosis are often asymptomatic and may remain unrecognised for years. To determine the extent to which cirrhosis is unrecognised in a US Veteran population with HCC, and to evaluate the association between lack of cirrhosis recognition and stage of HCC at diagnosis. We reviewed the electronic medical records of a random sample of HCC cases diagnosed in the national Veterans Affairs system between 2005 and 2011. We conducted multivariable analyses adjusting for patients' demographics, comorbidity, aetiology of underlying disease and healthcare utilisation including HCC surveillance. Of 1201 patients with HCC and cirrhosis, 24.6% had unrecognised cirrhosis prior to HCC diagnosis. Older patients [>65 years, odds ratio (OR) 2.32], African Americans (OR 1.93), patients with alcoholic or NAFLD liver disease (OR 1.69 and 4.77 respectively), HIV (OR 3.02), and fewer comorbidities (Deyo 0 vs. 3, OR 2.42) had significantly higher odds of having unrecognised cirrhosis than comparison groups. Furthermore, patients with unrecognised cirrhosis were 6.5 times more likely to have advanced stage HCC at diagnosis. The ef...Continue Reading

References

Oct 13, 1999·Seminars in Liver Disease·J M LlovetJ Bruix
May 23, 2001·JAMA : the Journal of the American Medical Association·UNKNOWN Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
Dec 12, 2003·Lancet·Josep M LlovetJordi Bruix
Oct 27, 2005·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jordi BruixUNKNOWN Practice Guidelines Committee, American Association for the Study of Liver Diseases
Mar 30, 2007·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Paul AnguloChristopher P Day
Dec 31, 2008·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Valérie ParadisJacques Belghiti
Jun 22, 2010·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Riccardo Lencioni
Jun 26, 2010·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jessica A DavilaHashem B El-Serag
Sep 14, 2010·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Ju Dong YangLewis R Roberts
Dec 4, 2010·International Journal of Cancer. Journal International Du Cancer·Judith ErtleAli Canbay
Feb 15, 2011·Therapeutic Advances in Gastroenterology·Hashem B El-Serag, Jessica A Davila
Oct 14, 2011·The New England Journal of Medicine·Hashem B El-Serag
Aug 1, 2012·Cancer Prevention Research·Amit G SingalJasmin A Tiro
Oct 9, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Donna L WhiteHashem B El-Serag
Jan 30, 2013·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jessica A DavilaHashem B El-Serag
May 17, 2013·The New England Journal of Medicine·Scott D HolmbergMaxine M Denniston
Jul 16, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Eimile Dalton-FitzgeraldAmit G Singal
Aug 15, 2014·The American Journal of Medicine·Amit G SingalAdam Yopp
Aug 15, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Christopher E McGowanPaul H Hayashi
Aug 26, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Sahil MittalJessica A Davila
Oct 8, 2014·Journal of Clinical Gastroenterology·Steven ScaglioneMichael L Volk
Aug 1, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Sumeet K Asrani

❮ Previous
Next ❯

Citations

Aug 18, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·David S GoldbergDavid E Kaplan
Feb 18, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Zobair M YounossiSharon Hunt
Jan 2, 2018·World Journal of Clinical Oncology·Adnan Said, Aiman Ghufran
Jul 12, 2018·European Journal of Gastroenterology & Hepatology·Chung-Yu ChangJaw-Ching Wu
Aug 7, 2018·Transplantation·Maria ReigChristian Toso
Jul 11, 2020·Journal of the Chinese Medical Association : JCMA·Hsiao-Sheng LuMing-Chih Hou
Jun 13, 2020·The American Journal of Gastroenterology·Neehar D ParikhElliot B Tapper
Feb 1, 2020·Journal of Translational Medicine·Chen Hao JiangJian Ming Hu
Jul 15, 2020·BMC Gastroenterology·Tongai Gibson MapongaMonique I Andersson
Aug 24, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Changqing ZhaoMindie H Nguyen
Aug 24, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Cheng-Feng JanYung-Po Liaw
Feb 6, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Yamini NatarajanFasiha Kanwal
May 10, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Erin WolfAmit G Singal
Nov 5, 2020·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Florian GeltingerMark Rinnerthaler
Sep 23, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Amit G SingalNeehar D Parikh
Aug 26, 2018·Gastroenterology·Fasiha KanwalHashem B El-Serag
Apr 23, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Elliot B Tapper, Neehar D Parikh
Jun 24, 2017·Gastroenterology·Fasiha KanwalHashem B El-Serag

❮ Previous
Next ❯

Related Concepts

Related Feeds

HIV/AIDS-Related Malignancies

HIV/AIDS infection increases the risk of non-communicable diseases common in the aged including HIV/AIDS-related malignancies. Discover the latest research in HIV/AIDS-related malignancies.

Related Papers

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
Luci K LeykumKyriakos P Papadopoulos
Journal of Gastroenterology and Hepatology
William KempStuart K Roberts
Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
Sahil MittalJessica A Davila
© 2022 Meta ULC. All rights reserved