Impact of hepatocellular cancer screening on early diagnostics and overall survival: own data

Abstract

Introduction. An increase in the life expectancy of patients with HCC can be achieved both by improving treatment methods and by implementing early examination through screening programs.Aim. Evaluation of the impact of screening in risk groups on early detection of HCC, on the possibility of specialized treatment, on one-year overall survival of patients with HCC.Materials and methods. The clinical records of 148 patients with HCC and liver cirrhosis (LC) who received medical care at the Sverdlovsk Regional Oncology Center in 2022 with the follow-up period exceeding 12 months were retrospectively studied. HCC was diagnosed as a result of screening carried out on the basis of the Regional Hepatological Center in 34 patients. 114 patients were referred to the oncological hospital due to the detection of a malignant tumor in liver during examination in cause of complaints. The compared groups of patients did not differ in age and sex composition, in the frequency of smoking, alcohol consumption, drug addiction, viral hepatitis B, obesity, diabetes mellitus, arterial hypertension, oncological heredity, in the distribution of LC by class. Patients with HCC detected at screening had a better general somatic status (p < 0.001), more often had viral hepatitis C (82.4% vs. 35.1%, p < 0.001) and AFP above normal (64.7% vs. 43.0%, p = 0.027).Results. Screening influenced the staging of newly diagnosed patients with HCC. If the proportion of stages B and C according to the Barcelona system remained the same, then stage A accounted for 32.4% versus 12.3% (OR = 3.42; 95% CI 1.37–8.49; p = 0.007). Stage D, on the contrary, was less: 8.8% vs. 36.8% (OR = 0.17; 95% CI 0.05–0.58; p = 0.002). Identification at earlier stages and better general condition of patients influenced the possibilities and results of treatment. In the HCC group after screening more patients received treatment: 88.2% versus 56.1% (OR = 5.86; 95% CI 1.94–17.73; p < 0.001). There was a higher one-year overall survival: 79.4% vs 39.5% (OR = 5.91; 95% CI 2.38–14.73; p < 0.001).Conclusion. Screening for HCC in risk groups improves early diagnosis, increases the likelihood of patients receiving specialized anticancer treatment and increases the one-year overall survival rate.