5th World Congress on Cancer Therapy
University of Alabama, USA
Title: Hepatocellular carcinoma screening in Cirrhosis: Inappropriate use of CT / MRI scan
Biography: Ashwani K Singal
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 confi rm HCC when suspicious lesions are noted on the US examination. However, CT / MRI scan is oft en 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 fi les containing 100% HCC cases, 5% cases of other cancers and 5% non-cancer Medicare benefi ciaries. 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 classifi ed 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 benefi t from use of CT/MRI.