Socioeconomic disparities in access to a hepatocellular carcinoma screening program in Brazil
OBJECTIVES: Cirrhotic patients must receive an abdominal ultrasound every 6 months as part of hepatocellular carcinoma (HCC) screening. The aim of this study was to assess if HCC screening was performed as recommended by the literature and to observe the differences between the private and public se...
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doaj-5c0957f1a9a943a191377b60eafd5de32020-11-25T00:07:24ZengFaculdade de Medicina / USPClinics1980-532271736136410.6061/clinics/2016(07)01S1807-59322016000700361Socioeconomic disparities in access to a hepatocellular carcinoma screening program in BrazilIzabelle Venturini SignorelliPatrícia Lofêgo GonçalvesLuciana Lofêgo GonçalvesLuiz Sérgio Emery FerreiraAna Tereza Parpaiola MendonçaGustavo Leite FranklinMaria da Penha Zago GomesOBJECTIVES: Cirrhotic patients must receive an abdominal ultrasound every 6 months as part of hepatocellular carcinoma (HCC) screening. The aim of this study was to assess if HCC screening was performed as recommended by the literature and to observe the differences between the private and public services in Brazil. METHODS: We analyzed data from the HCC screenings of 253 cirrhotic patients from the University Hospital (n=177) and private sector (n=76) in Vitória, ES, Brazil. RESULTS: Ultrasound screening was performed every 13.1 months on average (SD 9.02). In 37 out of 253 patients, the screenings were performed close to the recommended frequency; 16 were performed every 6 months, and 21 were mostly performed during the follow-up period every 6 months. In the remaining 216 cases, ultrasounds were not performed according to the guidelines; for 106 patients, less than 50% of all ultrasounds were performed every 6 months and 110 patients showed an interval greater than one year. Patients from the private sector received ultrasound screenings near the ideal in 28.9% of cases, while patients from the University Hospital received ultrasounds in only 8.4% of cases (p<0.0001). HCC was diagnosed in 30 patients (11.8%). For these 30 patients, 11 screenings were properly performed within 6 months (36.6%) and only 1 out of the 11 (9%) met the criteria for transplant. In the remaining 19 patients who did not receive the screening within 6 months, 6 (31.5%) did not meet the criteria for transplant. CONCLUSION: HCC screening in our environment was irregularly performed, mainly in the public service setting, which prevented early diagnosis in a large number of patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322016000700361&lng=en&tlng=enHepatocellular CarcinomaMass ScreeningDiagnosisLiver Cirrhosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Izabelle Venturini Signorelli Patrícia Lofêgo Gonçalves Luciana Lofêgo Gonçalves Luiz Sérgio Emery Ferreira Ana Tereza Parpaiola Mendonça Gustavo Leite Franklin Maria da Penha Zago Gomes |
spellingShingle |
Izabelle Venturini Signorelli Patrícia Lofêgo Gonçalves Luciana Lofêgo Gonçalves Luiz Sérgio Emery Ferreira Ana Tereza Parpaiola Mendonça Gustavo Leite Franklin Maria da Penha Zago Gomes Socioeconomic disparities in access to a hepatocellular carcinoma screening program in Brazil Clinics Hepatocellular Carcinoma Mass Screening Diagnosis Liver Cirrhosis |
author_facet |
Izabelle Venturini Signorelli Patrícia Lofêgo Gonçalves Luciana Lofêgo Gonçalves Luiz Sérgio Emery Ferreira Ana Tereza Parpaiola Mendonça Gustavo Leite Franklin Maria da Penha Zago Gomes |
author_sort |
Izabelle Venturini Signorelli |
title |
Socioeconomic disparities in access to a hepatocellular carcinoma screening program in Brazil |
title_short |
Socioeconomic disparities in access to a hepatocellular carcinoma screening program in Brazil |
title_full |
Socioeconomic disparities in access to a hepatocellular carcinoma screening program in Brazil |
title_fullStr |
Socioeconomic disparities in access to a hepatocellular carcinoma screening program in Brazil |
title_full_unstemmed |
Socioeconomic disparities in access to a hepatocellular carcinoma screening program in Brazil |
title_sort |
socioeconomic disparities in access to a hepatocellular carcinoma screening program in brazil |
publisher |
Faculdade de Medicina / USP |
series |
Clinics |
issn |
1980-5322 |
description |
OBJECTIVES: Cirrhotic patients must receive an abdominal ultrasound every 6 months as part of hepatocellular carcinoma (HCC) screening. The aim of this study was to assess if HCC screening was performed as recommended by the literature and to observe the differences between the private and public services in Brazil. METHODS: We analyzed data from the HCC screenings of 253 cirrhotic patients from the University Hospital (n=177) and private sector (n=76) in Vitória, ES, Brazil. RESULTS: Ultrasound screening was performed every 13.1 months on average (SD 9.02). In 37 out of 253 patients, the screenings were performed close to the recommended frequency; 16 were performed every 6 months, and 21 were mostly performed during the follow-up period every 6 months. In the remaining 216 cases, ultrasounds were not performed according to the guidelines; for 106 patients, less than 50% of all ultrasounds were performed every 6 months and 110 patients showed an interval greater than one year. Patients from the private sector received ultrasound screenings near the ideal in 28.9% of cases, while patients from the University Hospital received ultrasounds in only 8.4% of cases (p<0.0001). HCC was diagnosed in 30 patients (11.8%). For these 30 patients, 11 screenings were properly performed within 6 months (36.6%) and only 1 out of the 11 (9%) met the criteria for transplant. In the remaining 19 patients who did not receive the screening within 6 months, 6 (31.5%) did not meet the criteria for transplant. CONCLUSION: HCC screening in our environment was irregularly performed, mainly in the public service setting, which prevented early diagnosis in a large number of patients. |
topic |
Hepatocellular Carcinoma Mass Screening Diagnosis Liver Cirrhosis |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322016000700361&lng=en&tlng=en |
work_keys_str_mv |
AT izabelleventurinisignorelli socioeconomicdisparitiesinaccesstoahepatocellularcarcinomascreeningprograminbrazil AT patricialofegogoncalves socioeconomicdisparitiesinaccesstoahepatocellularcarcinomascreeningprograminbrazil AT lucianalofegogoncalves socioeconomicdisparitiesinaccesstoahepatocellularcarcinomascreeningprograminbrazil AT luizsergioemeryferreira socioeconomicdisparitiesinaccesstoahepatocellularcarcinomascreeningprograminbrazil AT anaterezaparpaiolamendonca socioeconomicdisparitiesinaccesstoahepatocellularcarcinomascreeningprograminbrazil AT gustavoleitefranklin socioeconomicdisparitiesinaccesstoahepatocellularcarcinomascreeningprograminbrazil AT mariadapenhazagogomes socioeconomicdisparitiesinaccesstoahepatocellularcarcinomascreeningprograminbrazil |
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