{"doi":"10.1002/hep.26944","title":"Hepatocellular carcinoma screening in patients with compensated hepatitis C virus (HCV)-related cirrhosis aware of their HCV status improves survival: A modeling approach","abstract":"<jats:sec>\n            <jats:title/>\n            <jats:p>Because of the ongoing debate on the benefit of ultrasound (US) screening for hepatocellular carcinoma (HCC), we assessed the impact of screening on hepatitis C virus (HCV)-related compensated cirrhosis patients aware of their HCV status. A Markov model simulated progression from HCC diagnosis to death in 700 patients with HCV-related compensated cirrhosis aware of their HCV status to estimate life expectancy (LE) and cumulative death at 5 years. Five scenarios were compared: S1, no screening; S2, screening by currently existing practices (57% access and effectiveness leading to the diagnosis of 42% at Barcelona Clinic Liver Cancer stage [BCLC-0/A]); S3, S2 with increased access (97%); S4, S2 with an efficacy of screening close to that achieved in a randomized controlled trial leading to the diagnosis of 87% of patients at stage BCLC-0/A; S5, S3+S4. The analysis was corrected for lead-time bias. Currently existing practices of HCC screening increased LE by 11 months and reduced HCC mortality at 5 years by 6% compared to no screening (<jats:italic toggle=\"yes\">P</jats:italic> = 0.0013). Compared to current screening practices, we found that: 1) increasing the rate of access to screening would increase LE by 7 months and reduce HCC mortality at 5 years by 5% (<jats:italic toggle=\"yes\">P</jats:italic> = 0.045); 2) optimal screening would increase LE by 14 months and reduce HCC mortality at 5 years by 9% (<jats:italic toggle=\"yes\">P</jats:italic> = 0.0002); 3) the combination of an increased rate of access and optimal effectiveness of HCC screening would increase LE by 31 months and decrease HCC mortality at 5 years by 20% (<jats:italic toggle=\"yes\">P</jats:italic> &lt; 0.0001). <jats:italic toggle=\"yes\">Conclusion</jats:italic>: The present study shows that US screening for HCC in patients with compensated HCV-related cirrhosis aware of their HCV status improves survival and emphasizes the crucial role of screening effectiveness. (HEPATOLOGY 2014;59:1471-1481)</jats:p>\n          </jats:sec>","journal":"Hepatology","year":2014,"id":672104,"datarank":0.5983476069846413,"base_score":3.9889840465642745,"endowment":3.9889840465642745,"self_citation_contribution":0.5983476069846413,"citation_network_contribution":0.0,"self_endowment_contribution":0.5983476069846413,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":53,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1755942,"name":"Sylvie Deuffic-Burban","orcid":null,"position":1,"is_corresponding":false},{"id":1755943,"name":"Nathalie Ganne-Carrié","orcid":null,"position":2,"is_corresponding":false},{"id":1755944,"name":"Thibaud Renaut-Vantroys","orcid":null,"position":3,"is_corresponding":false},{"id":1755945,"name":"Isabelle Rosa","orcid":null,"position":4,"is_corresponding":false},{"id":1755946,"name":"Anne-Marie Bouvier","orcid":null,"position":5,"is_corresponding":false},{"id":1755947,"name":"Guy Launoy","orcid":null,"position":6,"is_corresponding":false},{"id":1572746,"name":"Stephane Cattan","orcid":null,"position":7,"is_corresponding":false},{"id":604818,"name":"Alexandre Louvet","orcid":"0000-0002-5293-007X","position":8,"is_corresponding":false},{"id":604824,"name":"Sébastien Dharancy","orcid":"0000-0002-8262-5607","position":9,"is_corresponding":false},{"id":1755948,"name":"Jean-Claude Trinchet","orcid":null,"position":10,"is_corresponding":false},{"id":410033,"name":"Yazdan Yazdanpanah","orcid":"0000-0001-9445-1117","position":11,"is_corresponding":false},{"id":604821,"name":"Philippe Mathurin","orcid":"0000-0003-3447-2025","position":12,"is_corresponding":false},{"id":1755941,"name":"Abbas Mourad","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Hepatocellular carcinoma screening in patients with compensated hepatitis C virus (HCV)-related cirrhosis aware of their HCV status improves survival: A modeling approach","abstract":"<jats:sec>\n            <jats:title/>\n            <jats:p>Because of the ongoing debate on the benefit of ultrasound (US) screening for hepatocellular carcinoma (HCC), we assessed the impact of screening on hepatitis C virus (HCV)-related compensated cirrhosis patients aware of their HCV status. A Markov model simulated progression from HCC diagnosis to death in 700 patients with HCV-related compensated cirrhosis aware of their HCV status to estimate life expectancy (LE) and cumulative death at 5 years. Five scenarios were compared: S1, no screening; S2, screening by currently existing practices (57% access and effectiveness leading to the diagnosis of 42% at Barcelona Clinic Liver Cancer stage [BCLC-0/A]); S3, S2 with increased access (97%); S4, S2 with an efficacy of screening close to that achieved in a randomized controlled trial leading to the diagnosis of 87% of patients at stage BCLC-0/A; S5, S3+S4. The analysis was corrected for lead-time bias. Currently existing practices of HCC screening increased LE by 11 months and reduced HCC mortality at 5 years by 6% compared to no screening (<jats:italic toggle=\"yes\">P</jats:italic> = 0.0013). Compared to current screening practices, we found that: 1) increasing the rate of access to screening would increase LE by 7 months and reduce HCC mortality at 5 years by 5% (<jats:italic toggle=\"yes\">P</jats:italic> = 0.045); 2) optimal screening would increase LE by 14 months and reduce HCC mortality at 5 years by 9% (<jats:italic toggle=\"yes\">P</jats:italic> = 0.0002); 3) the combination of an increased rate of access and optimal effectiveness of HCC screening would increase LE by 31 months and decrease HCC mortality at 5 years by 20% (<jats:italic toggle=\"yes\">P</jats:italic> &lt; 0.0001). <jats:italic toggle=\"yes\">Conclusion</jats:italic>: The present study shows that US screening for HCC in patients with compensated HCV-related cirrhosis aware of their HCV status improves survival and emphasizes the crucial role of screening effectiveness. 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