Hepatocellular carcinoma (HCC) is a significant global health problem, and its incidence is expected to exceed 1 million new HCC annually by 2025.1 The reported 3-year survival rate for advanced-stage HCC is less than 17%, while 70% of patients diagnosed with early-stage HCC can achieve 5-year survival.2 Despite well-established guidelines and the clear benefits of early detection, the meta-analysis results (29 papers, 1 18 799 patients) showed that only 24% of individuals at risk for developing HCC were screened.3 Efforts to surmount barriers at patient, provider and healthcare levels have shown a minimal screening rate increase over time.3 4 One of the reasons for the disappointing results might be the fact that authors focused on individual barriers, rather than considering the screening failure the result of the interplay of different factors. Additionally, the published studies have the following limitations, detailed reasons for screening failure are missing, the majority of the studies are done in single centre and the results generalisability is not possible, the definition of HCC screening differs per study, short follow-up periods.2 3 Singal et al have to be commended for their work published recently in Gut .5 The authors conducted a multicentre (three centres) randomised clinical trial between April …

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邮寄外展和患者导航是改善 HCC 筛查的完美解决方案吗？


肝细胞癌 （HCC） 是一个重大的全球健康问题，预计到 2025 年，其发病率每年将超过 100 万例新发 HCC。据报道，晚期 HCC 的 3 年生存率低于 17%，而 70% 被诊断为早期 HCC 的患者可以达到 5 年生存率。2 尽管有完善的指南和早期发现的明显好处， 荟萃分析结果（29 篇论文，1 18 799 名患者）显示，只有 24% 的有患 HCC 风险的个体接受了筛查。3 克服患者、提供者和医疗保健层面障碍的努力表明，随着时间的推移，筛查率的提高很小。4 结果令人失望的原因之一可能是作者关注个体障碍， 而不是将筛选失败视为不同因素相互作用的结果。此外，已发表的研究存在以下局限性，缺少筛查失败的详细原因，大多数研究是在单一中心完成的，结果不可能推广，HCC 筛查的定义因研究而异，随访期短.2 3 Singal 等人最近发表在 Gut .5 的工作必须受到赞扬.5 作者在 4 月期间进行了一项多中心（三个中心）随机临床试验......