{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:45:26Z","timestamp":1786977926538,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2001,12,18]],"date-time":"2001-12-18T00:00:00Z","timestamp":1008633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2002,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Although previous studies have demonstrated the ability of ultrasonography (US) screening to detect small asymptomatic hepatocellular carcinoma (HCC), the efficacy of US screening in reducing deaths from HCC still remained unresolved. A 2\u2010stage screening program was designed to identify a high risk group in 7 townships in Taiwan by 6 markers (of risk for HCC) and repeated US screening was further applied to those with at least 1 positive result for the 6 markers, with a range of 3\u2010 to 6\u2010month inter\u2010screening intervals to those with liver cirrhosis or other chronic liver diseases and an annual screening regime for the remaining subjects with normal findings according to US. The 4,843 subjects in this cohort were followed up for an average of 7 years. We compared 4,385 attenders with 458 non\u2010attenders, in conjunction with baseline assessment for self\u2010selection bias. In addition, we assessed baseline variables with respect to their effects on risk of incidence of and mortality from HCC and on risk of incidence of liver cirrhosis. The difference in mortality between attenders and non\u2010attenders was then re\u2010estimated adjusting for significant predictors of cirrhosis, HCC incidence and HCC death as a further guard against baseline differences between attenders and non\u2010attenders in risk profiles. Results of US screening for this high risk group found the mortality was lower by 24% (95% CI: \u221252 to 62%) in the attenders compared to the non\u2010attenders. After adjustment for sensitivity, the mean sojourn time (MST) were 1.57 (95% CI: 0.94\u20134.68) for subjects with liver cirrhosis and 2.66 (95% CI: 1.68\u20136.37) years for non\u2010cirrhotic patient. Significant increases in risk of HCC incidence were associated with increasing age, male gender, hepatitis B surface antigen positive (HbsAg), hepatitis C antibody positive (Anti\u2010HCV), high levels of alanine transaminase (ALT) and alpha\u2010fetoprotein (AFP) and a family history of HCC. Significantly increased risks of liver cirrhosis were associated with predictors of cirrhosis were increasing age, HbsAg, high levels of ALT and of AFP. Significant or borderline significant increases in risk of HCC death were associated with increasing age, male gender, HbsAg, high levels of AST and AFP. Adjusted for the significant variables, the mortality was lower by 41% (95% CI: \u221220 to 71%,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.1446) in the attenders compared to the non\u2010attenders. The present study provides suggestive evidence on the efficacy of US screening in a selective high risk group in an endemic area of hepatitis B. A randomized controlled trial would yield definitive evidence. Within the protocol of such a trial, a shorter interscreening interval for patients with liver cirrhosis is suggested. \u00a9 2001 Wiley\u2010Liss, Inc.\n                  <\/jats:p>","DOI":"10.1002\/ijc.10122","type":"journal-article","created":{"date-parts":[[2004,11,9]],"date-time":"2004-11-09T03:44:36Z","timestamp":1099971876000},"page":"257-261","source":"Crossref","is-referenced-by-count":112,"title":["Ultrasound screening and risk factors for death from hepatocellular carcinoma in a high risk group in Taiwan"],"prefix":"10.1002","volume":"98","author":[{"given":"Tony Hsiu\u2010Hsi","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Jen","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Fang","family":"Yen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng\u2010Nan","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010An","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guan\u2010Tarn","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Ming","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan\u2010Shu","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Duffy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2001,12,18]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0016-5085(84)80020-7","article-title":"Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on utility of real\u2010time ultrasonography","volume":"86","author":"Shinagawa T","year":"1984","journal-title":"Gastroenterology"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850801)56:3<660::AID-CNCR2820560338>3.0.CO;2-F"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840120411"},{"key":"e_1_2_6_5_2","first-page":"1189","article-title":"Ultrasound follow\u2010up of patients at risk for hepatocellular carcinoma: results of a prospective study on 360 cases","volume":"91","author":"Solmi L","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(05)80613-0"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(86)90919-4"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(05)80468-4"},{"key":"e_1_2_6_9_2","first-page":"519","article-title":"Early detection of hepatocellular carcinoma in patients with cirrhosis by alpha\u2010fetoprotein, ultrasound and fine\u2010needle biopsy","volume":"36","author":"Tremolda F","year":"1989","journal-title":"Hepato\u2010Gastroenterology"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(89)90528-3"},{"key":"e_1_2_6_11_2","first-page":"916","article-title":"Hepatocellular carcinoma in Italian patients with liver cirrhosis","volume":"83","author":"Colombo M","year":"1991","journal-title":"N Engl J Med"},{"key":"e_1_2_6_12_2","first-page":"432","article-title":"Screening for hepatocellular carcinoma in chronic carriers of hepatitis B virus: incidence and prevalence of hepatocellular carcinoma in a North American urban population","volume":"1995","author":"Sherman M","journal-title":"Hepatology"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)90863-7"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19941015)74:8<2234::AID-CNCR2820740805>3.0.CO;2-6"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199509000-00014"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.1997.tb00513.x"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19880515)61:10<1942::AID-CNCR2820611003>3.0.CO;2-J"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)90585-7"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/1040-8428(94)90020-5"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19881101)62:9<2051::AID-CNCR2820620930>3.0.CO;2-1"},{"key":"e_1_2_6_21_2","first-page":"5621","article-title":"Association between hepatitis C virus antibodies and hepatocellular carcinoma","volume":"51","author":"Yu MW","year":"1991","journal-title":"Cancer Res"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.1890430315"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19910115)67:2<429::AID-CNCR2820670218>3.0.CO;2-#"},{"key":"e_1_2_6_24_2","first-page":"2842","article-title":"Hepatitis C and B in the etiology of hepatocellular carcinoma in the Japanese population","volume":"51","author":"Tanaka K","year":"1991","journal-title":"Cancer Res"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/162.4.817"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840130303"},{"key":"e_1_2_6_27_2","volume-title":"Epidemiologic research","author":"Kleinbaum DG","year":"1982"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780141404"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.2307\/2988469"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/20.1.1"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.2307\/2533681"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268898001022"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fijc.10122","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.10122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T10:43:54Z","timestamp":1696848234000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.10122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,12,18]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2002,3,10]]}},"alternative-id":["10.1002\/ijc.10122"],"URL":"https:\/\/doi.org\/10.1002\/ijc.10122","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,12,18]]}}}