Nicole J Kim1, Karine Rozenberg-Ben-Dror2, David A Jacob3, Kristin Berry4, George N Ioannou1,4. 1. Division of Gastroenterology, University of Washington, Seattle, Washington, USA. 2. Veterans Affairs Great Lakes Health Care System, VISN 12 PBM, Westchester, Illinois, USA. 3. Veterans Affairs Heart of Texas Health Care Network, VISN 17 PBM, Arlington, Texas, USA. 4. Division of Gastroenterology, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
Abstract
INTRODUCTION: We evaluated the coronavirus disease 2019 (COVID-19) pandemic's impact on hepatocellular carcinoma (HCC) screening and diagnosis among patients with cirrhosis in the Veterans Health Administration. METHODS: Rates and predictors of screening and diagnosis were reviewed September 1, 2019-February 29, 2020 ("pre-COVID-19," N = 94,612) and April 1, 2020-September 30, 2020 ("post-COVID-19," N = 88,073). RESULTS: Screening and diagnosis rates declined by 44% and 13%, respectively, after the COVID-19 pandemic. Screening declined irrespective of liver disease severity, but diagnosis declined only in Model for End Stage Liver Disease-Sodium score <20 or Fibrosis-4 score <3.25. Fibrosis-4 score ≥3.25 and HCC risk ≥1.5%/year strongly predicted HCC diagnosis but only moderately predicted receipt of screening. DISCUSSION: Screening and diagnosis rates declined after the COVID-19 pandemic. Prioritizing screening for patients at greatest risk for HCC may reduce delays in diagnosis.
INTRODUCTION: We evaluated the coronavirus disease 2019 (COVID-19) pandemic's impact on hepatocellular carcinoma (HCC) screening and diagnosis among patients with cirrhosis in the Veterans Health Administration. METHODS: Rates and predictors of screening and diagnosis were reviewed September 1, 2019-February 29, 2020 ("pre-COVID-19," N = 94,612) and April 1, 2020-September 30, 2020 ("post-COVID-19," N = 88,073). RESULTS: Screening and diagnosis rates declined by 44% and 13%, respectively, after the COVID-19 pandemic. Screening declined irrespective of liver disease severity, but diagnosis declined only in Model for End Stage Liver Disease-Sodium score <20 or Fibrosis-4 score <3.25. Fibrosis-4 score ≥3.25 and HCC risk ≥1.5%/year strongly predicted HCC diagnosis but only moderately predicted receipt of screening. DISCUSSION: Screening and diagnosis rates declined after the COVID-19 pandemic. Prioritizing screening for patients at greatest risk for HCC may reduce delays in diagnosis.
Authors: Nicole J Kim; David A Jacob; George N Ioannou; Binu V John; Shari Rogal; Karine Rozenberg-Ben-Dror Journal: Am J Gastroenterol Date: 2021-02-01 Impact factor: 10.864
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Authors: Oren K Fix; Bilal Hameed; Robert J Fontana; Ryan M Kwok; Brendan M McGuire; David C Mulligan; Daniel S Pratt; Mark W Russo; Michael L Schilsky; Elizabeth C Verna; Rohit Loomba; David E Cohen; Jorge A Bezerra; K Rajender Reddy; Raymond T Chung Journal: Hepatology Date: 2020-07 Impact factor: 17.298