Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE.
Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE.
Ann Glob Health. 2017 Mar-Apr;83(2):281-292. doi: 10.1016/j.aogh.2017.02.002. Epub 2017 Apr 19.
Hepatocellular carcinoma (HCC) is among the leading causes of cancer deaths in China. Considering its poor prognosis when diagnosed late, Chinese guidelines recommend biannual screening for HCC with abdominal ultrasound and serum α-fetoprotein (AFP) test for high-risk populations.
To investigate the practice, knowledge, and self-perceived barriers for HCC screening among high-risk hospital patients in China.
An interview-based questionnaire was conducted among Chinese patients with chronic hepatitis B and/or chronic hepatitis C infection from outpatient clinics at 2 tertiary medical institutions in Shanghai and Wuhan, China.
Among 352 participating patients, 50.0% had routine screening, 23.3% had irregular screening, and 26.7% had incomplete or no screening. Significant determinants for screening included higher level of education, underlying liver cirrhosis, a family history of HCC, and better knowledge concerning viral hepatitis, HCC, and HCC screening guidelines. Moreover, factors associated with better knowledge were younger age, female gender, urban residency, education level of college or above, annual household income of greater than 150,000 RMB, and longer duration of hepatitis infection. The 3 most common barriers reported for not receiving screening were not aware that screening for HCC exists (41.5%), no symptoms or discomfort (38.3%), and lack of recommendation from physicians (31.9%).
Health care professionals and community leaders should actively inform patients regarding the benefits of HCC screening through design of educational programs. Such interventions are expected to increase knowledge about HCC and HCC screening, as well as improve screening adherence and earlier diagnosis.
肝细胞癌（HCC）是中国癌症死亡的主要原因之一。鉴于其晚期诊断预后较差，中国指南建议对高危人群进行半年一次的 HCC 筛查，包括腹部超声和血清甲胎蛋白（AFP）检测。
调查中国高危医院患者 HCC 筛查的实践、知识和自我感知障碍。
在中国上海和武汉的 2 家三级医疗机构的门诊，对慢性乙型肝炎和/或慢性丙型肝炎感染的中国患者进行了基于访谈的问卷调查。
在 352 名参与患者中，50.0%进行了常规筛查，23.3%进行了不规则筛查，26.7%进行了不完整或没有筛查。筛查的显著决定因素包括较高的教育水平、潜在的肝硬化、肝癌家族史，以及对病毒性肝炎、肝癌和肝癌筛查指南的更好了解。此外，与更好的知识相关的因素是年龄较小、女性、城市居住、大学或以上学历、家庭年收入大于 150,000 人民币，以及肝炎感染时间较长。未接受筛查的三个最常见的障碍是不知道存在 HCC 筛查（41.5%）、无症状或不适（38.3%）和缺乏医生推荐（31.9%）。
医疗保健专业人员和社区领导人应通过设计教育计划，积极告知患者 HCC 筛查的益处。这种干预措施有望提高对 HCC 和 HCC 筛查的认识，以及提高筛查的依从性和早期诊断。
