Perspectives of physicians regarding screening patients at risk of hepatocellular carcinoma.
Perspectives of physicians regarding screening patients at risk of hepatocellular carcinoma.
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DOI：
10.1093/gastro/gou089
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发表时间：
2016-08
影响因子：
3.6
通讯作者：
Gohel TD
中科院分区：
文献类型：
--
作者：
Bharadwaj S;Gohel TD
背景和目的：筛查肝细胞癌高危患者有助于疾病的早期发现，改善预后。肝细胞癌最常见的原因包括慢性病毒性肝炎感染，即乙肝、丙型肝炎和肝硬变。这项研究的目的是评估参与肝癌高危患者管理的医生对筛查的认识。方法：对3个学术中心的300名医生进行邮寄问卷调查。主要的结果衡量标准是医生对当前的肝细胞癌筛查指南的了解程度。从调查问卷中获得人口统计学和临床变量。结果：调查问卷有效率为59.0%，其中教职员工(n = )129人，住院医师(n = )46人，研究员(n = )2人。被调查者的专业领域依次为内科(62.1%)、全科(16.4%)、消化科(15.3%)、肿瘤科(3.4%)和其他(2.8%)。对慢性乙肝和慢性丙型肝炎继发肝硬变患者进行肝癌筛查的医生分别为163人(92.1%)和167人(94.4%)，其中35.0%的医生每6个月使用甲胎蛋白(AFP)，22.0%的医生每6个月使用影像手段筛查肝癌。此外，22名内科医生(12.4%)没有检查血清AFP水平，33名医生(18.6%)从未使用成像来筛查肝细胞癌。结论：大多数参与研究的医生都筛查了肝癌的高危患者。然而，大多数医生并没有采用最合适的筛查方式(即成像)，而更多地依赖于AFP水平。
Background and aims: Screening patients at risk for hepatocellular carcinoma (HCC) facilitates early detection of disease, with improved outcome. The most common causes of HCC include chronic viral hepatitis infection—namely hepatitis B, hepatitis C, and cirrhosis. The aim of this study was to assess the awareness of screening among physicians involved in the management of patients at risk for HCC. Methods: Three hundred physicians from three academic centers were invited to participate in a mailed survey questionnaire. The main outcome measure was physicians' knowledge of the current HCC screening guidelines. Demographic and clinical variables were obtained from the survey questionnaire. Results: A total of 177 (59.0%) out of the 300 invited physicians responded to the survey questionnaire, including faculty members (n = 129), residents (n = 46), and fellows (n = 2). The specialty areas of the responding physicians were internal medicine (62.1%), family medicine (16.4%), gastroenterology (15.3%), oncology (3.4%) and others (2.8%). The number of physicians who performed HCC screening in patients with cirrhosis secondary to chronic hepatitis B and chronic hepatitis C infection were 163 (92.1%) and 167 (94.4%), respectively; 35.0% of them used alpha-fetoprotein (AFP) every 6 months, while 22.0% used imaging modalities every 6 months to screen for HCC. Further, 22 physicians (12.4%) did not check for serum AFP levels and 33 (18.6%) never used imaging to screen for HCC. Conclusion: The majority of the participating physicians screen high-risk patients for HCC. However, the most appropriate modality of screening (i.e. imaging) is not employed by most physicians and there is greater reliance on AFP levels.