Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan

Yen Po Yeh, Tsung Hui Hu, Po Yuan Cho, Hsiu Hsi Chen, Amy Ming Fang Yen, Sam Li Sheng Chen, Sherry Yueh Hsia Chiu, Jean Ching Yuan Fann, Wei Wen Su, Yi Jen Fang, Shih Tien Chen, Hsiao Ching San, Hung Pin Chen, Chao Sheng Liao

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1840-1849
Number of pages10
JournalHepatology
Volume59
Issue number5
DOIs
Publication statusPublished - 2014

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Mass Screening
Taiwan
Hepatocellular Carcinoma
Ultrasonography
Mortality
Confidence Intervals
Virus Diseases
Hepatitis B virus
Vaccination

ASJC Scopus subject areas

  • Hepatology

Cite this

Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan. / Yeh, Yen Po; Hu, Tsung Hui; Cho, Po Yuan; Chen, Hsiu Hsi; Yen, Amy Ming Fang; Chen, Sam Li Sheng; Chiu, Sherry Yueh Hsia; Fann, Jean Ching Yuan; Su, Wei Wen; Fang, Yi Jen; Chen, Shih Tien; San, Hsiao Ching; Chen, Hung Pin; Liao, Chao Sheng.

In: Hepatology, Vol. 59, No. 5, 2014, p. 1840-1849.

Research output: Contribution to journalArticle

Yeh, YP, Hu, TH, Cho, PY, Chen, HH, Yen, AMF, Chen, SLS, Chiu, SYH, Fann, JCY, Su, WW, Fang, YJ, Chen, ST, San, HC, Chen, HP & Liao, CS 2014, 'Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan', Hepatology, vol. 59, no. 5, pp. 1840-1849. https://doi.org/10.1002/hep.26703
Yeh, Yen Po ; Hu, Tsung Hui ; Cho, Po Yuan ; Chen, Hsiu Hsi ; Yen, Amy Ming Fang ; Chen, Sam Li Sheng ; Chiu, Sherry Yueh Hsia ; Fann, Jean Ching Yuan ; Su, Wei Wen ; Fang, Yi Jen ; Chen, Shih Tien ; San, Hsiao Ching ; Chen, Hung Pin ; Liao, Chao Sheng. / Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan. In: Hepatology. 2014 ; Vol. 59, No. 5. pp. 1840-1849.
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abstract = "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.",
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AU - Chen, Sam Li Sheng

AU - Chiu, Sherry Yueh Hsia

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AU - Su, Wei Wen

AU - Fang, Yi Jen

AU - Chen, Shih Tien

AU - San, Hsiao Ching

AU - Chen, Hung Pin

AU - Liao, Chao Sheng

PY - 2014

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N2 - 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.

AB - 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.

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