Guideline for stratified screening and surveillance of primary liver cancer(2020 Edition).
10.3760/cma.j.cn112152-20201109-00970
- VernacularTitle:原发性肝癌的分层筛查与监测指南(2020版)
- Collective Name:Professional Committee for Prevention and Control of Hepatobiliary and Pancreatic Diseases of Chinese Preventive Medicine Association;;Professional Committee for Hepatology, Chinese Research Hospital Association;;Chinese Society of Hepatology, Chinese Medical Association;;Prevention of Infection Related Cancer (PIRCA) Group, Specialist Committee of Cancer Prevention and Control of Chinese Preventive Medicine Association
- Publication Type:Journal Article
- Keywords:
Chronic hepatitis B;
Cirrhosis;
Liver neoplasms;
Screening;
Surveillance
- MeSH:
Carcinoma, Hepatocellular;
China/epidemiology*;
Early Detection of Cancer;
Hepatitis B, Chronic;
Humans;
Liver Cirrhosis;
Liver Neoplasms/epidemiology*
- From:
Chinese Journal of Hepatology
2021;29(1):25-40
- CountryChina
- Language:Chinese
-
Abstract:
The age-adjusted incidence of primary liver cancer (PLC) has been declining in China. However, PLC cases in China account for 55% globally. The disease burden is still high and the 5-year survival rate was not improved significantly in the past two decades. This guideline outlines PLC screening in the risk populations, both in hospital and community. Liver cirrhosis and chronic hepatitis B are the main causes of PLC in China. For better PLC surveillance and screening in clinical practices, it is recommended to stratify population at the risk into 4 risk levels, namely, low-risk, intermediate-risk, high-risk, and extremely high-risk.The lifelong surveillance is suggested for those at the risk of PLC. The intervals and tools for surveillance and screening are recommended based on the risk levels. Abdominal ultrasonography combined with serum alpha-fetoprotein examination (routine surveillance) every 6 months is recommended for those at a high risk of PLC.Routine surveillance every 3 months and enhanced CT/MRI examination every 6-12 months are recommended for those at an extremely high risk of PLC. The surveillance interval can be extended every 1 year or longer for those at a low-risk or at an intermediate-risk of PLC, because their annual incidence of PLC is very low. The cost-effectiveness of these recommendations remains to be evaluated.