[Randomized controlled prospective study of secondary prevention for primary liver cancer]

Abstract

Objective: To evaluated the effectiveness of secondary prevention for primary liver cancer (PLC).

Methods: This is a randomized controlled study. 18,816 Shanghai urban residents, aged 35-55, with serum evidence of HBV infection or chronic hepatitis were randomly assigned into the screening group (9,373) or the control group (9,443). In the screening group, participants were tested with serum AFP and real time ultrasound every 6 months, while in the control group, participants were not informed about the study and received no screening. Participants with positive results underwent a diagnostic evaluation, and all patients diagnosed as PLC were treated appropriately and followed up.

Results: After 5 years of study, there were 22,631.5 person-years screened. 86 patients with PLC were detected. 51 patients were detected in the control group within 32,944 person-years. In the screened group, 60.5% (52/86) of patients were in stage I, and 45.3% (40/86) with small liver cancer. However, there were no patients in stage I or with small liver cancer in the control group. The resection rates were 46.5% in the screened group, and 7.8% in the control group. The 1 to 5 years survival rates of PLC patients in the screening group were 65.0%, 65.0%, 52.7%, 52.7% and 52.7%, respectively, and in the control group were 30.0%, 6.5%, 0%, 0% and 0%, respectively.

Conclusion: Screening can detect PLC in the early stage, and improve the prognosis of PLC, indicating that secondary prevention can decrease the mortality of PLC.