Arguedas Miguel R
Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, MCLM 281, 1918 University Boulevard, Birmingham, AL 35294, USA.
Curr Gastroenterol Rep. 2003 Feb;5(1):57-62. doi: 10.1007/s11894-003-0010-1.
Hepatocellular carcinoma (HCC) is a major public health concern in many areas of the world, and its incidence is increasing in the United States and other countries. Screening for HCC in patients with cirrhosis has been advocated to identify those with small lesions who would benefit from transplantation or surgical resection. Despite these recommendations, several issues regarding screening remain controversial. No randomized, controlled trials have confirmed that surveillance for HCC reduces disease-specific mortality. In addition, the most appropriate screening test and optimal screening interval have not yet been defined. Clearly, these unresolved questions have a major impact on the cost-effectiveness of a screening program either at the population or the clinic level. A few studies, however, have suggested that screening may be cost-effective because a minor survival benefit could result in a cost that is acceptable to decision makers.
肝细胞癌（HCC）是世界上许多地区主要的公共卫生问题，在美国和其他国家其发病率正在上升。对于肝硬化患者进行HCC筛查，一直被提倡用于识别那些能从移植或手术切除中获益的小病灶患者。尽管有这些建议，但关于筛查的几个问题仍存在争议。尚无随机对照试验证实对HCC的监测能降低疾病特异性死亡率。此外，最合适的筛查试验和最佳筛查间隔尚未确定。显然，这些未解决的问题对人群或临床层面筛查项目的成本效益有重大影响。然而，一些研究表明筛查可能具有成本效益，因为微小的生存获益可能带来决策者可接受的成本。
