Routine liver cancer screening may offer good value for more people with alcohol-associated cirrhosis than current guidelines assume, according to a modeling study led by Harvard Medical School and Harvard T.H. Chan School of Public Health researchers at Massachusetts General Hospital.
Guidelines recommend twice-yearly screening when a person’s annual risk of liver cancer is above 1 percent. That cutoff comes largely from older studies of people with viral hepatitis; risk in alcohol-associated cirrhosis is often lower.
Using a computer simulation, the team found that screening with ultrasound and a blood test was cost-effective at an annual risk as low as 0.45 percent. Screening caught more cancers at earlier, more treatable stages, whether or not patients still drank alcohol.
“Our study shows that the 1 percent benchmark for screening is out of date for this population,” said senior and corresponding author Jagpreet Chhatwal, HMS associate professor of radiology at Mass General.
The average benefit per person was modest, but the results align with other recent models suggesting that the guidelines may need updating. The study was published Oct. 15 in Clinical Gastroenterology and Hepatology.
Read the full story from Mass General Brigham.
Authorship, funding, disclosures
Ali Hajjar is first author on the study. Additional authors are Jovan Julien, Gizem Nemutlu, H. Mert Sahinkoc, Mary Linton B. Peters, and Fasiha Kanwal.
This work was supported by the National Institutes of Health (P01CA263025, U01CA23099, K08CA248473, and P30DK56338) and the Cancer Prevention and Research Institute of Texas (RP220119 and RP150587).
The authors report no conflicts of interest relevant to this work.
