Improved survival with screening for hepatocellular carcinoma

Hepatocellular cancer (HCC) is a frequent cause of cancer death worldwide. Although successful screening programs exist in Asian countries, the role f or screening in the United States is not clear. The purpose of this study i s to determine if screening has an effect on survival in a predominantly As ian population in Hawaii, We retrospectively reviewed cases of HCC from 199 3 to 1998 for demographic data, risk factors, symptoms, stage, treatment, a nd survival. Patients were divided into 3 groups according to presentation: symptomatic (S), asymptomatic (A), and asymptomatic but screened for disea se (A/Sc). Kaplan-Meier analysis was performed on overall survival by group . Ninety-one patients were referred for HCC. There were 56 patients in grou p S, 19 patients in group A, and 16 patients in group A/Sc. Patients in gro up A/Sc survived significantly longer than those in group S (P = .009), wit h the former group having a median survival of 1,399 versus 234 days for gr oup S, Median survival for group A was 545 days and did not differ signific antly from the other groups. Patients who are asymptomatic and screened for HCC have an increased survival compared with those patients who present wi th symptoms. This may justify the use of a formal screening program for HCC in Hawaii, but we would need to investigate this prospectively.