{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:40:23Z","timestamp":1784698823097,"version":"3.55.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,9,9]],"date-time":"2017-09-09T00:00:00Z","timestamp":1504915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Hepatocellular carcinoma (<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>) surveillance is associated with improved outcomes and long\u2010term survival. Our goal is to evaluate adherence rates to <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> surveillance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a systematic search of the PubMed and Scopus databases and abstract search of relevant studies from recent major liver meetings. All searches and data extraction were performed independently by two authors. Analysis was via random\u2010effects models and multivariate meta\u2010regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 22 studies (n\u00a0=\u00a019\u00a0511) met inclusion criteria (original non\u2010interventional studies with defined cirrhosis or chronic hepatitis B or chronic hepatitis C with advanced fibrosis populations, and surveillance tests and intervals). Overall adherence rate was 52% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 38%\u201066%). Adherence was significantly higher in cirrhotic patients compared to chronic hepatitis B and other high\u2010risk patients, in European compared to North American studies, in less than 12\u2010month compared to yearly surveillance intervals, and in prospective compared to retrospective studies (71%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 64%\u201078% vs 39%, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 26%\u201051%, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>.001). The between\u2010study heterogeneity of all above analyses was significant (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>.001). Only the study design (retrospective vs prospective cohort) had statistical significance in a multivariate meta\u2010regression model (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>.05) and could account for some of the differences above.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall adherence rate to <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> surveillance was suboptimal at 52% with no significant differences by liver disease aetiology or study location in multivariate meta\u2010regression analysis. Further research and educational efforts are needed to improve the current rate of <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> surveillance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13555","type":"journal-article","created":{"date-parts":[[2017,8,20]],"date-time":"2017-08-20T11:06:36Z","timestamp":1503227196000},"page":"503-514","source":"Crossref","is-referenced-by-count":81,"title":["Poor adherence to hepatocellular carcinoma surveillance: A systematic review and meta\u2010analysis of a complex issue"],"prefix":"10.1111","volume":"38","author":[{"given":"Changqing","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Cirrhosis Institute of Liver Disease Shuguang Hospital Shanghai University of T. C. M.  Shanghai China"},{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingjuan","family":"Jin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto CA USA"},{"name":"Department of Epidemiology and Biostatistics School of Public Health Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Hieu","family":"Le","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Huan","family":"Le","sequence":"additional","affiliation":[{"name":"University of California  Santa Cruz CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Lingzhi","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Jin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University Medical Center  Palo Alto CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2863-9389","authenticated-orcid":false,"given":"Grace Lai\u2010Hung","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Wai\u2010Sun","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Hong Kong 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