摘要
Background and aims:Screening patients at risk for hepatocellular carcinoma(HCC)facilitates early detection of disease,with improved outcome.The most common causes of HCC include chronic viral hepatitis infection—namely hepatitis B,hepatitis C,and cirrhosis.The aim of this study was to assess the awareness of screening among physicians involved in the management of patients at risk for HCC.Methods:Three hundred physicians from three academic centers were invited to participate in a mailed survey questionnaire.The main outcome measure was physicians’knowledge of the current HCC screening guidelines.Demographic and clinical variables were obtained from the survey questionnaire.Results:A total of 177(59.0%)out of the 300 invited physicians responded to the survey questionnaire,including faculty members(n=129),residents(n=46),and fellows(n=2).The specialty areas of the responding physicians were internal medicine(62.1%),family medicine(16.4%),gastroenterology(15.3%),oncology(3.4%)and others(2.8%).The number of physicians who performed HCC screening in patients with cirrhosis secondary to chronic hepatitis B and chronic hepatitis C infection were 163(92.1%)and 167(94.4%),respectively;35.0%of them used alpha-fetoprotein(AFP)every 6 months,while 22.0%used imaging modalities every 6 months to screen for HCC.Further,22 physicians(12.4%)did not check for serum AFP levels and 33(18.6%)never used imaging to screen for HCC.Conclusion:The majority of the participating physicians screen high-risk patients for HCC.However,the most appropriate modality of screening(i.e.imaging)is not employed by most physicians and there is greater reliance on AFP levels.
背景与目的:对具有肝癌风险的患者进行筛查有助于肝癌的早期诊断,从而改善预后。肝癌最常见的病因包括慢性病毒性肝炎(如乙肝、丙肝)和肝硬化。本研究目的是评估医生对肝癌高危患者筛查的认识。方法:来自3个医疗中心的300名医生受邀参加了此次邮件问卷调查。主要结局指标是医生对目前的肝癌筛查指南的认识。通过问卷收集人口统计学资料及临床资料。结果:300名受邀的医生中有177人(59.0%)完成了问卷,其中机构医生129人,住院医生46人,规培医生2人。按照专业,内科医生占62.1%,家庭医生占16.4%,胃肠专科医生占15.3%,肿瘤科医生占3.4%,其他2.8%。分别有163名(92.1%)和167名(94.4%)的医生会对由慢性乙型和丙型肝炎继发的肝硬化患者进行肝癌筛查;其中35%的医生采用每6月一次的甲胎蛋白(AFP)检测进行筛查,22.0%的医生采用每6月一次的影像学筛查。而有22名(12.4%)医生不会进行血清AFP检测,33名(18.6%)医生从未使用过影像学筛查。结论:大多数参加调查的医生都会对高危人群进行肝癌筛查,但最合理的筛查方法(如影像学检查)并没有为大多数医生采用,他们更多的是依赖AFP的检测。
