1Departments of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. 2Departments of Biostatistics, Yonsei University College of Medicine, Seoul, Korea. 3Departments of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. gihankhys@yumc.yonsei.ac.kr
ABSTRACT
PURPOSE: To evaluate the effectiveness of clinic-based screening program for early detection of hepatocellular carcinoma (HCC) and to assess the risk factors of HCC in Korea.
MATERIALS AND METHODS: The data of 14,259 patients who had ultrasonography (US) due to chronic liver diseases were collected into a data base program from 1990 to 1998.
RESULTS: A total of 4,339 patients were enrolled who had repeated US. 237 patients were diagnosed as HCC during follow-up (mean 33 months). The tumor size detected by screening within a 6-months interval was significantly smaller than that of a longer interval (2.7 cm vs 3.9 cm, P<0.01). The smaller the tumor was at detection, the longer the survival time was. Only 29.9% of HCC patients had an elevated serum alpha-fetoprotein (alphaFP) level above 400 ng/ml.
Multivariate analysis showed liver cirrhosis, chronic hepatitis B or C and old age over 40 years to be significantly associated with an increased risk of HCC.
CONCLUSION: The US screening within a 6-months interval is beneficial to high-risk patients over 40 years old through the early detection of HCC and prolonged survival. According to the risk factors, the necessity for screening test and proper interval should be reconsidered.
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