Surveillance for liver cancer in primary care: A systematic review of the evidence
Details
Publication Year 2023-11,Volume 52,Issue #11,Page 801-807
Journal Title
Australian Journal of General Practice
Publication Type
Review
Abstract
BACKGROUND AND OBJECTIVES: In Australia, mortality rates for hepatocellular carcinoma (HCC) are rising. Targeted surveillance is recommended to increase early diagnosis. The aim of this study was to synthesise evidence regarding HCC surveillance in primary care and identify barriers and facilitators to surveillance. METHOD: A systematic review was performed, with searches conducted in five biomedical databases, the Centre for Reviews and Dissemination website and the grey literature. Study quality was assessed using the National Institute for Heath and Care Excellence (NICE) quality appraisal checklists. RESULTS: In all, 32 studies, focusing on viral hepatitis and cirrhosis patients, were included in the review. HCC surveillance rates were lower for patients managed by primary care providers (PCPs) than for those managed by gastroenterologists/hepatologists. HCC surveillance rates increased when additional support was provided to PCPs (eg reminder systems, nurse follow-up). Key barriers were a lack of awareness of HCC risks and surveillance recommendations, as well as competing priorities PCPs must address when working with patients with multimorbidity. DISCUSSION: HCC surveillance programs in primary care should be accompanied by additional support for PCPs and strategies to increase awareness of clinical recommendations.
Keywords
Humans; *Liver Neoplasms/diagnosis/pathology; *Carcinoma, Hepatocellular/diagnosis/epidemiology; Liver Cirrhosis/complications/diagnosis; Early Detection of Cancer; Primary Health Care
Department(s)
Cancer Imaging
PubMed ID
37935142
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