TY - JOUR
T1 - Practice, Knowledge, and Barriers for Screening of Hepatocellular Carcinoma Among High-Risk Chinese Patients
AU - Xu, Kerui
AU - Watanabe-Galloway, Shinobu
AU - Rochling, Fedja A.
AU - Zhang, Jianjun
AU - Farazi, Paraskevi A.
AU - Peng, Hongyan
AU - Wang, Hongmei
AU - Luo, Jiangtao
N1 - Funding Information:
The study was supported by the Cancer Epidemiology Education in Special Populations (CEESP) Program of the University of Nebraska Medical Center from the National Cancer Institute (R25CA112383). The content of this project is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute.
Publisher Copyright:
© 2017 Icahn School of Medicine at Mount Sinai
PY - 2017/3
Y1 - 2017/3
N2 - Background Hepatocellular carcinoma (HCC) is among the leading causes of cancer deaths in China. Considering its poor prognosis when diagnosed late, Chinese guidelines recommend biannual screening for HCC with abdominal ultrasound and serum α-fetoprotein (AFP) test for high-risk populations. Objectives To investigate the practice, knowledge, and self-perceived barriers for HCC screening among high-risk hospital patients in China. Methods An interview-based questionnaire was conducted among Chinese patients with chronic hepatitis B and/or chronic hepatitis C infection from outpatient clinics at 2 tertiary medical institutions in Shanghai and Wuhan, China. Findings Among 352 participating patients, 50.0% had routine screening, 23.3% had irregular screening, and 26.7% had incomplete or no screening. Significant determinants for screening included higher level of education, underlying liver cirrhosis, a family history of HCC, and better knowledge concerning viral hepatitis, HCC, and HCC screening guidelines. Moreover, factors associated with better knowledge were younger age, female gender, urban residency, education level of college or above, annual household income of greater than 150,000 RMB, and longer duration of hepatitis infection. The 3 most common barriers reported for not receiving screening were not aware that screening for HCC exists (41.5%), no symptoms or discomfort (38.3%), and lack of recommendation from physicians (31.9%). Conlusions Health care professionals and community leaders should actively inform patients regarding the benefits of HCC screening through design of educational programs. Such interventions are expected to increase knowledge about HCC and HCC screening, as well as improve screening adherence and earlier diagnosis.
AB - Background Hepatocellular carcinoma (HCC) is among the leading causes of cancer deaths in China. Considering its poor prognosis when diagnosed late, Chinese guidelines recommend biannual screening for HCC with abdominal ultrasound and serum α-fetoprotein (AFP) test for high-risk populations. Objectives To investigate the practice, knowledge, and self-perceived barriers for HCC screening among high-risk hospital patients in China. Methods An interview-based questionnaire was conducted among Chinese patients with chronic hepatitis B and/or chronic hepatitis C infection from outpatient clinics at 2 tertiary medical institutions in Shanghai and Wuhan, China. Findings Among 352 participating patients, 50.0% had routine screening, 23.3% had irregular screening, and 26.7% had incomplete or no screening. Significant determinants for screening included higher level of education, underlying liver cirrhosis, a family history of HCC, and better knowledge concerning viral hepatitis, HCC, and HCC screening guidelines. Moreover, factors associated with better knowledge were younger age, female gender, urban residency, education level of college or above, annual household income of greater than 150,000 RMB, and longer duration of hepatitis infection. The 3 most common barriers reported for not receiving screening were not aware that screening for HCC exists (41.5%), no symptoms or discomfort (38.3%), and lack of recommendation from physicians (31.9%). Conlusions Health care professionals and community leaders should actively inform patients regarding the benefits of HCC screening through design of educational programs. Such interventions are expected to increase knowledge about HCC and HCC screening, as well as improve screening adherence and earlier diagnosis.
KW - barriers
KW - hepatocellular carcinoma
KW - high-risk Chinese patients
KW - knowledge
KW - screening
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U2 - 10.1016/j.aogh.2017.02.002
DO - 10.1016/j.aogh.2017.02.002
M3 - Article
C2 - 28619403
AN - SCOPUS:85017504407
VL - 83
SP - 281
EP - 292
JO - Mount Sinai Journal of Medicine
JF - Mount Sinai Journal of Medicine
SN - 0027-2507
IS - 2
ER -