ABSTRACT
Objective@#To evaluate the patients′ survival and effectiveness of the live cancer screening for population at high risk for liver cancer in Qidong.@*Methods@#According to the Expert Scheme proposed the Expert Committee of Early Detection and Early Treatment, China Cancer Foundation, diagnostical screening by using combined methods of alpha-fetoprotein and B ultrasound monitoring were carried out biannually in individuals with positive HBsAg who were screened from Qidong area. The evaluation indices of the effectiveness are task completion rate of screening, detection rate of liver cancer, early diagnosis rate, and treatment rate. The deadline of the follow-up for the surviving outcome was March 31, 2016. The life-table method was used to calculate the observed survival, and to make comparison and significant tests between survival rates in Group A (those found via repeated periodic screening) and Group B (those diagnosed without periodic screening).@*Results@#Since 2007, 38 016 target population have been screened, and 3 703(9.74%) individuals with positive HBsAg were found. Except for 29 patients with liver cancer at the initial screening, 3 674 persons in the cohort were followed up; 268 patients with liver cancer were detected from the 33 199 person-times screening, with an annual detection rate of 1.61%. Of them, 186 patients were found in Group A(1.12%), in which 149 patients were the early cases, with an early detection rate of 80.11%; 167 out of 186(89.78%) patients received treatment after diagnosis. The incidence of liver cancer in this HBsAg (+ ) cohort of 25 452 person-years was 1 052.96 per 100 000 annually, 187 cases in males(1 488.45/100 000)and 81 cases in females(628.46/100 000). The 1-, 3-, 5-, and 8-year survival of all patients with liver cancer were 64.55%, 40.50%, 32.54%, and 19.65%, respectively. The 1-, 3-, 5-, and 8-year survival rates were 77.16%, 49.04%, 38.53%, and 24.25% in Group A, and were 36.25%, 21.21%, 21.21%, and 0% in Group B, respectively, with significant differences between two groups (P<0.05).@*Conclusion@#The findings show that screening of individuals at high-risk of development of liver cancer, with semiannual AFP and B ultrasound, according to the Expert Scheme, is effective not only in increasing detection rate but also in detecting liver cancer at early stage, and in improving patients′ survival as well.
ABSTRACT
Objective To explore the relationship of hepatitis B virus surface antigen(HBsAg)infec-tion and family history of hepatocellular carcinoma(HCC)with age at primary liver cancer. Methods Totally 1 359 cases of primary liver cancer were enrolled. Their data of sex,HBsAg status and family history informa-tions of liver cancer were analyzed on the associations with diagnosis age. Results Of the 1 359 cases,1 053 were males and 306 were females,their average age at diagnosis was(54. 02 ± 10. 47)years(20-84 years). For HBsAg positive cases,the average age at diagnosis was 51. 99,significantly younger than that of HBsAg negative cases(61. 23),t = 13. 51,P = 0. 000. Cases with family history of HCC were diagnosed at a signifi-cantly earlier age than those without family history(52. 53 vs 55. 23,t = 4. 389,P = 0. 000). In HBsAg posi-tive cases,the average age at diagnosis showed a significant difference not only between males and females (51. 18 vs 54. 89,t = 5. 353,P = 0. 000),but also between cases with family history and cases without family history(51. 33 vs 52. 62,t = 2. 233,P = 0. 026). In HBsAg negative cases,the average age at diagnosis of males and females were 60. 83 and 62. 45 respectively(t = 1. 126,P = 0. 261). The average age at diagnosis of cases with family history and cases without family history were 59. 58 and 61. 92 respectively(t = 1. 728,P =0. 085),both showed no significant difference. Conclusion Cases of primary liver cancer with positive-HBsAg are diagnosed averagely 9. 24 years younger than those with negative-HBsAg in Qidong. Sex and family history of HCC significantly advance hepatocarcinogenesis only in HBsAg positive individuals,not in HBsAg negative individuals.