{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T10:47:30Z","timestamp":1750330050279,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T00:00:00Z","timestamp":1714089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ultrasound surveillance for hepatocellular carcinoma (HCC) may improve early tumour detection but may additionally result in surveillance\u2010related harm through increased evaluation of non\u2010HCC lesions. The incidence of these outcomes has not been reported outside North America.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to report the outcomes of HCC surveillance with respect to both surveillance\u2010related benefits and harms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed all HCC surveillance ultrasounds at a large Victorian tertiary hospital network in 2017 and followed their outcomes until 2021. Surveillance\u2010related benefits were defined as early\u2010stage HCC detection. Surveillance\u2010related harm was defined as contrast imaging, biopsies or surgery performed to evaluate non\u2010HCC liver lesions or false\u2010positive alpha\u2010fetoprotein levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred and fifty\u2010three patients were included (mean age 54.5 \u00b1\u200912.3\u2009years, males 67.5%, cirrhosis 50.3%). The most common liver disease aetiology was hepatitis B (53.9%). Over a median of 4.7\u2009years follow\u2010up, early\u2010stage HCC was detected in 3.3% (5.4% in cirrhotic vs 1.1% in non\u2010cirrhotic patients, <jats:italic>P<\/jats:italic> &lt;\u20090.01). 75% of all HCCs were early\u2010stage. Surveillance\u2010related harm occurred in 12.5% (15.5% in cirrhotic vs 9.5% in non\u2010cirrhotic patients, <jats:italic>P<\/jats:italic> &lt;\u20090.04), although most harm was mild (12.1%). In subgroup analysis, the detection of early\u2010stage HCC ranged between 0% (screened outside of guideline criteria and alcoholic cirrhotic patients) and 7.2% (hepatitis C cirrhosis). Harm occurred between 9% (non\u2010cirrhotic hepatitis B) and 20.8% (thrombocytopenia).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our study, HCC surveillance was associated with early tumour detection, although many patients experienced mild surveillance\u2010related harm. Novel surveillance strategies and pathways are required to improve detection in high\u2010risk patients and minimise harm in low\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16405","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T11:19:02Z","timestamp":1714130342000},"page":"1360-1368","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes of hepatocellular carcinoma surveillance in Melbourne, Australia"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-6209","authenticated-orcid":false,"given":"Samuel","family":"Hui","sequence":"first","affiliation":[{"name":"Department of Medicine School of Clinical Sciences, Monash University  Melbourne Victoria Australia"},{"name":"Department of Gastroenterology and Hepatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suong","family":"Le","sequence":"additional","affiliation":[{"name":"Department of Medicine School of Clinical Sciences, Monash University  Melbourne Victoria Australia"},{"name":"Department of Gastroenterology and Hepatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anouk","family":"Dev","sequence":"additional","affiliation":[{"name":"Department of Medicine School of Clinical Sciences, Monash University  Melbourne Victoria Australia"},{"name":"Department of Gastroenterology and Hepatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Medicine School of Clinical Sciences, Monash University  Melbourne Victoria Australia"},{"name":"Department of Gastroenterology and Hepatology Monash Health  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,26]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"World Health Organization.International Agency for Research on Cancer. 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