Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 May;59(5):1840-9.
doi: 10.1002/hep.26703. Epub 2014 Apr 1.

Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan

Yen-Po Yeh  1 , Tsung-Hui Hu, Po-Yuan Cho, Hsiu-Hsi Chen, Amy Ming-Fang Yen, Sam Li-Sheng Chen, Sherry Yueh-Hsia Chiu, Jean Ching-Yuan Fann, Wei-Wen Su, Yi-Jen Fang, Shih-Tien Chen, Hsiao-Ching San, Hung-Pin Chen, Chao-Sheng Liao; Changhua Community-Based Abdominal Ultrasonography Screening Group
Collaborators, Affiliations
Free PMC article

Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan

Yen-Po Yeh et al. Hepatology. 2014 May.
Free PMC article

Abstract

Mass screening with abdominal ultrasonography (AUS) has been suggested as a tool to control adult hepatocellular carcinoma (HCC) in individuals, but its efficacy in reducing HCC mortality has never been demonstrated. This study aimed to assess the effectiveness of reducing HCC mortality by mass AUS screening for HCC based on a program designed and implemented in the Changhua Community-based Integrated Screening (CHCIS) program with an efficient invitation scheme guided by the risk score. We invited 11,114 (27.0%) of 41,219 eligible Taiwanese subjects between 45 and 69 years of age who resided in an HCC high-incidence area to attend a risk score-guided mass AUS screening between 2008 and 2010. The efficacy of reducing HCC mortality was estimated. Of the 8,962 AUS screening attendees (with an 80.6% attendance rate), a total of 16 confirmed HCC cases were identified through community-based ultrasonography screening. Among the 16 screen-detected HCC cases, only two died from HCC, indicating a favorable survival. The cumulative mortality due to HCC (per 100,000) was considerably lower in the invited AUS group (17.26) compared with the uninvited AUS group (42.87) and the historical control group (47.51), yielding age- and gender-adjusted relative mortality rates of 0.69 (95% confidence interval [CI]: 0.56-0.84) and 0.63 (95% CI: 0.52-0.77), respectively.

Conclusion: The residents invited to community-based AUS screening for HCC, compared with those who were not invited, showed a reduction in HCC mortality by ∼ 31% among subjects aged 45-69 years who had not been included in the nationwide vaccination program against hepatitis B virus infection.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Protocol of AUS screening in Changhua County.
Figure 2
Figure 2
Flowchart of findings from the AUS screen in Changhua County.
Figure 3
Figure 3
The ROC curves for KCIS used to train the risk score and the external validation dataset with CHCIS.
Figure 4
Figure 4
Cumulative mortality comparisons of the invited AUS group, the uninvited AUS group, and the historical control group (before the CHCIS program) in Changhua County.
See this image and copyright information in PMC

Comment in

References

    1. Chang MH, Chen CJ, Lai MS, Hsu HM, Wu TC, Kong MS. Universal hepatitis B vaccination in Taiwan and the incidence of hepatocellular carcinoma in children. Taiwan Childhood Hepatoma Study Group. N Engl J Med. 1997;336:1855–1859. , et al. - PubMed
    1. Shiina S, Tateishi R, Arano T, Uchino K, Enooku K, Nakagawa H. Radiofrequency ablation for hepatocellular carcinoma: 10-year outcome and prognostic factors. Am J Gastroenterol. 2012;107:569–577. , et al. - PMC - PubMed
    1. Tseng PL, Wang JH, Tung HD, Hung CH, Kee KM, Chen CH. Optimal treatment increased survival of hepatocellular carcinoma patients detected with community-based screening. J Gastroenterol Hepatol. 2010;25:1426–1434. , et al. - PubMed
    1. Chen TH, Chen CJ, Yen MF, Lu SN, Sun CA, Huang GT. Ultrasound screening and risk factors for death from hepatocellular carcinoma in a high risk group in Taiwan. Int J Cancer. 2002;98:257–261. , et al. - PubMed
    1. Chen TH, Chiu YH, Luh DL, Yen MF, Wu HM, Chen LS. Taiwan Community-Based Integrated Screening Group. Community-based multiple screening model: design, implementation, and analysis of 42,387 participants. Cancer. 2004;100:1734–1743. , et al. - PubMed