Hepatocellular carcinoma screening in Cirrhosis: Inappropriate use of CT / MRI scan

5^th World Congress on Cancer Therapy

September 28-30, 2015 Atlanta, USA

Ashwani K Singal

University of Alabama, USA

Scientific Tracks Abstracts: J Cancer Sci Ther

Abstract :

This lecture will address the inappropriate use of CT or MR scan for hepatocellular cancer (HCC) screening in patients with cirrhosis. American Association for Study of Liver Diseases recommends Ultrasound (USG) for HCC screening in cirrhosis. CT/MRI is used to confirm HCC when suspicious lesions are noted on the US examination. However, CT / MRI scan is often inappropriately used for screening in routine clinical practice. In this presentation, we would discuss and share data on the inappropriate use of CT or MR scans as analyzed using the SEER-Medicare Linked Database with files containing 100% HCC cases, 5% cases of other cancers and 5% non-cancer Medicare beneficiaries. Using the study cohort of cirrhotics with HCC aged 67 yrs. or more at the time of diagnosis and with complete Medicare enrollment, CT/MRI done between 6 and 12 mo. before HCC diagnosis was classified as inappropriate if the scan was done without claim for symptoms on CT/MRI or for HCC diagnosis and without US examination within 6 months prior to CT/MRI scan. Of all cirrhotics in this Medicare population, only 4% received screening and 30.6% of CT/MRI was done inappropriately. Apart from increasing health care cost, inappropriate CT/MRI also puts patients at risk for radiation exposure. Studies are needed for strategies to improve rigorous adherence to HCC screening and also identify high risk patients which may benefit from use of CT/MRI.

Biography :

Singal joined the UAB as an Assistant Professor in the Division of Gastroenterology and Hepatology of the Department of Medicine after completing Masters in Clinical Research from UTMB Galveston TX, and AASLD sponsored advanced fellowship in Transplant Hepatology at the Mayo Clinic, Rochester, MN. Singal is active in the Faculty practice with clinical and translational research interests of steatohepatitis (due to alcohol use as well as due to non-alcohol fatty liver disease), simultaneous liver-kidney transplantation, and porphyria cutanea tarda.

Email: aksingal@uab.edu