Please use this identifier to cite or link to this item:
Title: Hepatocellular carcinoma surveillance and quantile regression for determinants of underutilisation in at-risk Australian patients.
Austin Authors: Low, Elizabeth S L ;Apostolov, Ross ;Wong, Darren;Lin, Sandra;Kutaiba, Numan ;Grace, Josephine A ;Sinclair, Marie 
Affiliation: Gastroenterology and Hepatology
Victorian Liver Transplant Unit
Department of Radiology, Monash Health, Clayton 3168, Victoria, Australia
Issue Date: 15-Dec-2021
Publication information: World Journal of Gastrointestinal Oncology 2021; 13(12): 2149-2160
Abstract: While clinical guidelines recommend hepatocellular carcinoma (HCC) surveillance for at-risk individuals, reported surveillance rates in the United States and Europe remain disappointingly low. To quantify HCC surveillance in an Australian cohort, and assess for factors associated with surveillance underutilisation. All patients undergoing HCC surveillance liver ultrasounds between January 1, 2018 to June 30, 2018 at a tertiary hospital in Melbourne, Australia, were followed until July 31, 2020, or when surveillance was no longer required. The primary outcome was the percentage of time up-to-date with HCC surveillance (PTUDS). Quantile regression was performed to determine the impact of factors associated with HCC surveillance underutilisation. Among 775 at-risk patients followed up for a median of 27.5 months, the median PTUDS was 84.2% (IQR: 66.3%-96.3%). 85.0% of patients were followed up by specialist gastroenterologists. Amongst those receiving specialist care, quantile regression demonstrated differential associations at various quantile levels of PTUDS for several factors. Older age at the 25th quantile (estimate 0.002 per percent, P = 0.03), and cirrhotic status at the 75th quantile (estimate 0.021, P = 0.017), were significantly associated with greater percentage of time up-to-date. African ethnicity (estimate -0.089, P = 0.048) and a culturally and linguistically diverse (CALD) background (estimate -0.063, P = 0.01) were significantly associated with lower PTUDS at the 50th quantile, and again for CALD at the 75th quantile (estimate -0.026, P = 0.045). While median PTUDS in this Australian cohort study was 84.2%, awareness of the impact of specific factors across PTUDS quantiles can aid targeted interventions towards improved HCC surveillance.
DOI: 10.4251/wjgo.v13.i12.2149
ORCID: 0000-0002-0604-3920
PubMed URL: 35070048
PubMed URL:
ISSN: 1948-5204
Type: Journal Article
Subjects: Carcinoma, hepatocellular
Early detection of cancer
Hepatitis, viral, human
Liver cirrhosis
Liver neoplasms
Population surveillance
Appears in Collections:Journal articles

Show full item record

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.