ArticleClinical and translational gastroenterology2025
Hepatocellular Carcinoma Surveillance in Patients With Cirrhosis at US Safety-Net Health Systems.
Article in Clinical and translational gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Hepatocellular Carcinoma in Southeast Asian Americans: Epidemiologic Trends, Screening Challenges, and Policy Implications.Healthcare (Basel, Switzerland) · 2026Review
- Pandemic-Related Disruptions and Hepatocellular Carcinoma Surveillance in Safety-Net Settings.JAMA network open · 2026Article
- Disparities in Diagnosis, Management, and Outcomes of Hepatocellular Carcinoma: A Review of Global and Sociodemographic Factors.Journal of gastrointestinal cancer · 2026Review
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Authors and funding
11 authors.
Funding
Abstract
introductionSurveillance for hepatocellular carcinoma (HCC) in patients with cirrhosis is associated with improved patient outcomes. We aim to evaluate real-world utilization of HCC surveillance among safety-net populations with cirrhosis.
methodsWe performed a retrospective cohort study of adults with cirrhosis across 4 safety-net health systems from March 1, 2017, to February 28, 2022. Receipt of abdominal imaging with ultrasound, computed tomography, or magnetic resonance imaging and the corresponding ICD-9-CM / ICD-10-CM diagnosis codes at 6 months and 12 months were used to assess HCC surveillance.
resultsAmong 14,556 patients with cirrhosis (61.8% male, 73.0% non-White ethnic minorities, 54.4% with Medicaid or indigent care/uninsured), 70.9% and 78.1% received abdominal imaging agnostic to indication within 6 months and 12 months, respectively. When evaluating the receipt of abdominal imaging with a specific indication for HCC surveillance, 29.1% and 34.0% of patients received surveillance within 6 months and 12 months, respectively. On adjusted multivariable regression, greater odds of HCC surveillance were observed in older patients, ethnic minorities, and those with commercial insurance. Lower odds of HCC surveillance were observed in patients with indigent care (vs Medicare: odds ratio [OR] 0.85, 95% confidence interval [CI] 0.72-1.00), drug use (OR 0.63, 95% CI 0.55-0.71), and concurrent mental health/psychiatric diagnoses (OR 0.88, 95% CI 0.80-0.97). DISCUSSION: Among a multicenter safety-net cohort of patients with cirrhosis, fewer than 30% received HCC surveillance within 6 months. While greater proportions received abdominal imaging agnostic to indication, the clinical benefit of these examinations for HCC surveillance may be limited because of concerns with abbreviated protocols, quality, and interpretation.
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