Community-based mass ultrasonographic screening of hepatocellular carcinoma among thrombocytopenic adults

Sheng Nan Lu*, Jing Houng Wang, Pao Fei Chen, Hung Da Tung, Po Lin Tseng, Chao Hung Hung, Kwong Ming Kee, Chien Hung Chen, Kuo Chin Chang, Chuan Mo Lee, Chi Sin Changchien, Yao Der Chen, Lin San Tsai, Tony Hsiu Hsi Chen

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

20 Scopus citations

Abstract

Thrombocytopenia has been reported as a valid surrogate for liver cirrhosis and could be used to identify groups at high risk of hepatocellular carcinoma (HCC) for ultrasonographic (US) screening. We designed this two-stage community-based screening for HCC. In 2004, subjects (ages ≥40 years) were invited to undergo comprehensive health examinations, with 17,551 men (ages 63.0 ± 11.5 years) and 39,151 women (ages 59.9 ± 11.7 years) participating. Subjects with platelet counts <150 × 109/L or α-fetoprotein (AFP) >20 ng/mL were enrolled for the second-stage US screening; 3,242 subjects (5.7%; male/female, 1,415/1,827; age 66 ± 10 years) were candidates for US screening and 2,983 (92.2%) responded. Of 137 suspected cases, 124 (90.5%) complied with referral for confirmation and 72 (58.1%) were confirmed to be HCC cases (male/female, 41/31; age 68.1 ± 8.8 years). Screening with AFP, thrombocytopenia, or both could identify 0.64% (n = 364), 5.33% (n = 3,205), and 5.7% (n = 3,242) of the high-risk subjects from the population, estimated to include 50.5%, 54.5%, and 71.3% of all HCC cases. Among confirmed patients, tumor diameters were <3 cm for the 27 (37.5%) patients and 3 to 5 cm for the <3 (31.9%) patients. Only 5 (6.9%) patients' conditions were too advanced to be actively treated. This study enrolled only 5.7% of the participants for US, which cover 64.7% to 71.3% of the HCC cases. Most (93%) of the detected cases were caught early enough to undergo effective treatment modalities. This HCC screening protocol should be feasible, economical, and effective.

Original languageEnglish
Pages (from-to)1813-1821
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Volume17
Issue number7
DOIs
StatePublished - 07 2008

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