Conceptual Model for the Hepatocellular Carcinoma Screening Continuum: Current Status and Research Agenda.
Conceptual Model for the Hepatocellular Carcinoma Screening Continuum: Current Status and Research Agenda.
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DOI：
10.1016/j.cgh.2020.09.036
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发表时间：
2022-01
期刊：
影响因子：
--
通讯作者：
Parikh ND
中科院分区：
文献类型：
--
作者：
Singal AG;Lok AS;Feng Z;Kanwal F;Parikh ND
肝细胞癌 (HCC) 的预后仍然很差，5 年生存率低于 20%。这种不良的预后可能部分归因于癌症筛查过程连续过程中的失败，例如对高危患者的筛查以及对 HCC 患者的适当治疗未充分利用。更好地了解这些过程失败以及它们与其他癌症类型中所见的失败情况的比较，有助于了解潜在的干预目标和策略，以降低 HCC 相关死亡率。在此，我们概述了一个概念模型，其中包含 HCC 筛查过程连续体中的几个离散步骤，包括风险评估、筛查启动、筛查结果随访、诊断评估和治疗评估。该概念模型说明了筛查过程中的每个步骤如何容易出现延迟或失败，从而导致更糟糕的结果，例如晚期诊断或生存率低，以及患者、提供者和医疗保健系统层面的因素如何导致这些失败。我们将 HCC 癌症筛查流程与乳腺癌和结直肠癌筛查流程进行比较，以确定改进的机会。美国国家癌症研究所最近成立了转化性肝癌联盟，其目标是改善 HCC 的早期检测。旨在解决 HCC 筛查过程连续性失败问题的研究将有助于实现这一目标。
Hepatocellular carcinoma (HCC) continues to have a dismal prognosis, with 5-year survival below 20%. This poor prognosis can be in part attributed to failures along the cancer screening process continuum such as underuse of screening in at risk patients and appropriate treatments for patients with HCC. Better understanding these process failures, and how they compare to those seen in other cancer types, can help inform potential intervention targets and strategies to reduce HCC-related mortality. Herein, we outline a conceptual model with several discrete steps in the HCC screening process continuum including risk assessment, screening initiation, follow-up of screening results, diagnostic evaluation, and treatment evaluation. The conceptual model illustrates how each step in the screening process is prone to delays or failure, resulting in worse outcomes such as late stage diagnosis or poor survival, and how factors at the patient, provider, and health care system levels can contribute to these failures. We compare cancer screening processes for HCC with those employed in breast and colorectal cancer screening to identify opportunities for improvement. The Translational Liver Cancer consortium was recently established by the National Cancer Institute with the goal of improving early detection of HCC. Studies designed to address failures in the HCC screening process continuum will help accomplish this goal.
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影响因子：
29.4
作者：
Kanwal F;Kramer JR;Mapakshi S;Natarajan Y;Chayanupatkul M;Richardson PA;Li L;Desiderio R;Thrift AP;Asch SM;Chu J;El-Serag HB
通讯作者：
El-Serag HB
影响因子：
29.4
作者：
Serper M;Taddei TH;Mehta R;D'Addeo K;Dai F;Aytaman A;Baytarian M;Fox R;Hunt K;Goldberg DS;Valderrama A;Kaplan DE;VOCAL Study Group
通讯作者：
VOCAL Study Group
影响因子：
24.5
作者：
Nathani P;Gopal P;Rich N;Yopp A;Yokoo T;John B;Marrero J;Parikh N;Singal AG
通讯作者：
Singal AG
影响因子：
39.2
作者：
Carney, PA;Miglioretti, DL;Ballard-Barbash, R
通讯作者：
Ballard-Barbash, R
影响因子：
13.5
作者：
Rich, Nicole E.;John, Binu V.;Singal, Amit G.
通讯作者：
Singal, Amit G.