Screening for liver cancer may not lead to greater survival among patients infected with chronic hepatitis C virus, according to an evidence review.
Annals of Internal Medicine
Current guidelines recommend screening high-risk individuals for liver cancer, but the strength of evidence supporting these guidelines is unclear.
Researchers for the Veterans Health Administration conducted a systematic review of published literature to determine the benefits and harms of routine screening for liver cancer in patients with chronic hepatitis C virus (HCV). Twenty-two studies were included in the review. While screening could identify patients with earlier-stage disease who could benefit from treatment, the researchers found very-low-strength evidence about the effects of liver cancer screening on mortality.
Studies show that liver cancer has variable rates of progression and some patients may never experience symptoms. Diagnosing and treating patients for liver cancer that would never progress is an example of overtreatment. The researchers found no evidence examining rates of overdiagnosis in liver cancer screening. These findings neither support nor refute current clinical guidelines.
Annals of Internal Medicine – http://www.annals.org/article.aspx?doi=10.7326/M14-0558