Department of Medicine, University of California San Francisco, San Francisco General Hospital, 1001 Potrero Ave, NH-3D, San Francisco, CA 94110, USA.
Dig Dis Sci. 2011 May;56(5):1516-23. doi: 10.1007/s10620-010-1439-3. Epub 2010 Nov 3.
Physician patterns of screening for hepatitis B (HBV) and hepatocellular carcinoma (HCC) among Asian Americans are not well described.
To describe HBV and HCC screening practices among providers with large Asian American populations.
Providers within San Francisco's safety net system were surveyed with respect to HBV and HCC screening practices as well as knowledge, attitudes, and barriers to HCC screening.
Among the 109 respondents (response rate = 72%), 62% were aged >40, 65% female, 24% Asian, 87% primary care providers, and 48% had >25% Asian patients. Only 76% had screened >50% of their Asian patients for HBV and 43% had vaccinated >50% of eligible patients against HBV. Although 94% knew Asians were disproportionately affected by HCC, only 79% had screened for HCC in >50% of their Asian patients with chronic hepatitis B (CHB). A majority believed that HCC screening in CHB reduces HCC mortality (70%) and is cost-effective (57%). The most common HCC screening modality was AFP with abdominal ultrasound every 6-12 months (63%). Factors associated with HBV screening were familiarity with AASLD guidelines (OR 6.4, 95% CI 1.3-30.1, p = 0.02) and having vaccinated >50% of eligible patients against HBV (OR 2.2, 95% CI 1.1-4.5, p = 0.03). Factors associated with HCC screening using abdominal ultrasound every 6-12 months were having >25% Asian patients (OR = 4.5, 95% CI 1.3-15.3, p = 0.02) and higher HCC knowledge score (OR = 1.9 per item, 95% CI 1.01-3.6, p = 0.045).
HBV and HCC screening rates and HBV vaccination among Asians from physician report is suboptimal. HCC screening is associated with having more Asian patients and higher provider knowledge. Provider education is essential in increasing rates of HBV and HCC screening among Asian Americans.
亚洲裔美国人的乙型肝炎（HBV）和肝细胞癌（HCC）筛查模式尚未得到充分描述。
描述在亚洲裔人口较多的医疗机构中进行 HBV 和 HCC 筛查的情况。
对旧金山医疗保障系统内的医疗机构的提供者进行了调查，内容包括 HBV 和 HCC 筛查的实践、知识、对 HCC 筛查的态度和障碍。
在 109 名应答者中（应答率为 72%），62%的人年龄大于 40 岁，65%为女性，24%为亚洲人，87%为初级保健提供者，48%的患者中有超过 25%的亚洲人。只有 76%的人对其超过 50%的亚洲患者进行了 HBV 筛查，43%的人对符合条件的患者进行了 HBV 疫苗接种。尽管 94%的人知道亚洲人患 HCC 的比例过高，但只有 79%的人对其患有慢性乙型肝炎（CHB）的亚洲患者进行了 HCC 筛查。大多数人认为 HCC 筛查可以降低 CHB 患者的 HCC 死亡率（70%）并具有成本效益（57%）。最常见的 HCC 筛查方法是 AFP 联合腹部超声检查，每 6-12 个月一次（63%）。与 HBV 筛查相关的因素包括熟悉 AASLD 指南（OR 6.4，95%CI 1.3-30.1，p = 0.02）和对符合条件的患者进行了超过 50%的 HBV 疫苗接种（OR 2.2，95%CI 1.1-4.5，p = 0.03）。与每 6-12 个月进行一次腹部超声检查相关的 HCC 筛查因素包括患者中有超过 25%的亚洲人（OR = 4.5，95%CI 1.3-15.3，p = 0.02）和更高的 HCC 知识评分（OR = 1.9 分/项，95%CI 1.01-3.6，p = 0.045）。
根据医生报告，亚洲裔美国人的 HBV 和 HCC 筛查率和 HBV 疫苗接种率不理想。HCC 筛查与有更多的亚洲患者和更高的提供者知识水平有关。对提供者进行教育对于提高亚洲裔美国人的 HBV 和 HCC 筛查率至关重要。
