Performance and effectiveness of hepatocellular carcinoma screening in individuals with HBsAg seropositivity in China: a multicenter prospective study
Menée en Chine à partir de données portant sur 14 426 participants infectés par le virus de l'hépatite B, cette étude évalue l'efficacité d'un programme annuel de dépistage, basé sur le dosage sérique de l'alpha-foetoprotéine et une échographie, pour détecter précocement un carcinome hépatocellulaire et améliorer la survie
Current guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, including individuals with hepatitis B virus infection. However, the performance and survival benefits of annual screening have not been evaluated through multicenter prospective studies in a Chinese population. Between 2017 and 2021, we included 14,426 participants with hepatitis B surface antigen seropositivity in an annual HCC screening study in China using a multicenter prospective design with ultrasonography and serum alpha-fetoprotein. After four rounds of screening and follow-up, the adjusted hazard ratios of death after correction for lead-time and length-time biases for screen-detected cancers at the prevalent and incident rounds were 0.74 (95% confidence interval = 0.60–0.91) and 0.52 (95% confidence interval = 0.40–0.68), respectively. A meta-analysis demonstrated that HCC screening was associated with improved survival after adjusting for lead-time bias. Our findings highlight the ‘real-world’ feasibility and effectiveness of annual HCC screening in community settings for the early detection of HCC and to improve survival.
Nature Cancer , résumé, 2023