Mass screening for liver cancer: results from a demonstration screening project in Zhongshan City, China

作者：Mingfang Ji, Zhiwei Liu, Ellen T. Chang, Yu Xia, Biaohua Wu, Li Deng, Qianjin Feng, Kuangrong Wei, Xuejun Liang, Shifeng Lian, Quan Wen, Panpan Wang, Yun Du, Zhiheng Liang, Shenglin Xia, Hai Bo Lin, Fugui Li, Weimin Cheng, Weiqiang Chen, Yong Yuan, Weimin Ye · 发表于：Scientific Reports · 年份：2018 · DOI：10.1038/s41598-018-31119-9 · 被引用次数：32 · 研究领域：Hepatitis B Virus Studies、Liver Disease Diagnosis and Treatment、Hepatocellular Carcinoma Treatment and Prognosis

Current Chinese national guidelines recommend routine screening for liver cancer in patients positive for HBsAg, irrespective of fibrosis status, age, or family history of liver cancer. We aim to evaluate whether the recommended screening strategy could reduce liver-cancer-specific mortality. We conducted a liver cancer mass screening trial in Xiaolan Town, Zhongshan City, China, among residents aged 35-64 years in 2012. All volunteers were offered serological testing for hepatitis B virus surface antigen (HBsAg). We proposed biannual screening using serum alpha-fetoprotein (AFP) and ultrasonography examination for subjects positive for HBsAg. Among 17,966 participants (26.2% of 68,510 eligible residents) who were free of liver cancer at baseline in 2012, we identified 57 incident cases of liver cancer within the first 4 years of follow-up (i.e., 43 among 2,848 HBsAg-positive participants and 14 among 15,118 HBsAg-negative participants), compared with 104 cases identified in non-participants (N = 50,544). A total of 207 participants had the recommended number of ultrasonography examinations (every 6 months) during the screening period. Compared with cases identified from non-participants, the cases arising among participants were more likely to be at early stage and had better survival than those among non-participants. However, we did not observe a reduction in liver cancer-specific mortality rate among participants (relative risk = 1.04, 95% confidence interval = 0.68, 1.58...