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dc.contributor.authorQian, Mary Y Yen
dc.contributor.authorYuwei J, Rongen
dc.contributor.authorAngus, Peter Wen
dc.contributor.authorSchelleman, Tonyen
dc.contributor.authorJohnson, Lynneen
dc.contributor.authorGow, Paul Jen
dc.identifier.citationJournal of Gastroenterology and Hepatology; 25(5): 951-6en
dc.description.abstractWestern countries are seeing an increasing prevalence of chronic viral hepatitis and a subsequent rise in the incidence of hepatocellular carcinoma (HCC). Screening patients at high risk of HCC has become standard practice. The aim of this study was to assess the efficacy and cost of screening high-risk individuals for HCC in an Australian tertiary hospital.A retrospective review was performed of all patients who underwent HCC screening at the Austin Hospital in Melbourne between 1 October 1998 and 31 August 2004. HCC screening was carried out in all cirrhotic patients and male non-cirrhotic patients with chronic hepatitis B virus. Screening consisted of 6-monthly alpha fetoprotein (AFP) measurements and ultrasounds (US). Outcomes of those who had HCC detected were followed up until 15 February 2007. Patients who had HCC satisfying the Milan criteria for liver transplantation were considered to have potentially curable tumor. Costs for the diagnostic tests were obtained from the 2004 Australian Medicare Benefits Schedule.A total of 268 patient records were reviewed as part of the study. Chronic viral hepatitis accounted for 63% of the patients (n = 167). US screening was carried out at a median of 6.5 months and AFP measurements at a median of 4.0 months. HCC was detected in 22 patients (8.2%) at an incidence of 2.7% per year. These patients had a mean follow up of approximately 5.0 years after tumor detection. At the time of diagnosis, 17 patients had potentially curable tumor and 10 were alive at the conclusion of follow up. Of these 10 patients, six were successfully transplanted, three were successfully treated with radiological therapies and one was awaiting transplantation. The total cost of the screening program over the study period, including secondary investigations, was $A300,568. The cost per HCC detected was $13,662 and cost per potentially curable HCC was $17,680.An effective HCC screening program can be provided through a multi-disciplinary outpatient facility in an Australian teaching hospital. Further stratification of the high risk patient cohort may improve the cost effectiveness of this screening program.en
dc.subject.otherAged, 80 and overen
dc.subject.otherAmbulatory Care.economicsen
dc.subject.otherCarcinoma, Hepatocellular.diagnosis.economics.mortality.therapy.virologyen
dc.subject.otherCost-Benefit Analysisen
dc.subject.otherHepatitis B, Chronic.complicationsen
dc.subject.otherHospital Costsen
dc.subject.otherHospitals, Teaching.economicsen
dc.subject.otherLiver Cirrhosis.diagnosis.virologyen
dc.subject.otherLiver Neoplasms.diagnosis.economics.mortality.therapy.virologyen
dc.subject.otherMass Screening.economics.methodsen
dc.subject.otherMiddle Ageden
dc.subject.otherPredictive Value of Testsen
dc.subject.otherProgram Evaluationen
dc.subject.otherRetrospective Studiesen
dc.subject.otherTime Factorsen
dc.titleEfficacy and cost of a hepatocellular carcinoma screening program at an Australian teaching hospital.en
dc.typeJournal Articleen
dc.identifier.journaltitleJournal of Gastroenterology and Hepatologyen
dc.identifier.affiliationDepartment of Liver Transplantation, Austin Hospital, Heidelberg, Victoria, Australiaen
dc.type.austinJournal Articleen
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
item.openairecristype Liver Transplant Unit- and Hepatology- Liver Transplant Unit- and Hepatology-
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