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Meta-analysis: Ultrasound Liver Screening Saves Lives

May 26, 2014
Written by: , Filed in: Abdominal Imaging
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Cancer screening for people with cirrhosis of the liver, using ultrasound scans and blood tests, could significantly increase liver cancer survival rates, according to researchers at UT Southwestern Medical Center in Dallas and Emory University in Atlanta.

The researchers did a meta-analysis of 47 studies involving more than 15,000 patients. They published their results last month in PLOS Medicine. Amit Singal, MD, lead author of the article, explained why he’s such a strong advocate of the screening:

Curative therapies, such as surgery or a liver transplant, are only available if patients are found to have liver cancer at an early stage. Unfortunately, right now, only a minority of patients’ cancers are found at an early stage.

Dr. Singal is assistant professor of internal medicine and clinical sciences at UT Southwestern and medical director of the Liver Tumor Clinic in the Simmons Cancer Center at UT Southwestern. He was quoted in a UT Southwestern Medical Center news release.

The meta-analysis found that the three-year survival rate was 51 percent for cirrhosis patients who had received liver cancer screening, compared to 28 percent for patients who had not.

According to the news release, liver cancer is the third-leading cause of cancer deaths worldwide, and people with cirrhosis have a high risk of developing liver cancer: 3 to 5 percent per year. “We have a simple test, an abdominal ultrasound, which is painless and easy,” Dr. Singal said, “but we found that less than 20 percent of at-risk people have the test done, largely due to providers failing to order it.”

And why would they not order it? Well, the U.S. Preventive Services Task Force doesn’t recommend it, partly because a randomized study has not been done. But when a randomized study was attempted in 2005, not enough at-risk patients were willing to risk being randomly chosen not to get the screening.

“Just because we don’t have a randomized trial doesn’t mean there isn’t a benefit,” Dr. Singal said. He hopes the new study demonstrates that. “Part of our goal is providing evidence to both patients and physicians that liver cancer screening is beneficial.”

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Makers of scanners and other medical devices face a July 22 deadline to comply with tough new European Union standards—and the standards have nothing to do with the devices’ operation. For details, see our Facebook page.

Related CME seminar (up to 12.5 AMA PRA Category 1 credits™): UCSF Abdominal & Pelvic Imaging: CT/MR/US


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