Nurse-led screening may reduce risk of developing post-SVR liver cancer
23 October 2021
2 minutes to read
Source / Disclosures
Granel N, et al. Abstract OP095. Presented at: UEG Week; 3-5 October 2021 (virtual meeting).
Disclosures: Granel reports having received registrations for the Eisai congress.
Joining nurse-led screening programs may be a useful tool in reducing the risk of liver cancer in patients who have shown a sustained virologic response after hepatitis C, according to a presenter at UEG Week Virtual.
“The lifestyle changes the habits of SVR patients after [direct-acting antivirals], such as a significant increase in alcohol consumption and an increase in waist-to-hip ratio and BMI, [which] are well-known risk factors for liver disease and progression ”, Núria Granel, a member of the nursing staff of the Barcelona Clinic Liver Cancer group, said during his presentation. “Very high adherence to a nurse-led liver cancer screening program could be a useful strategy for modulating lifestyle and reducing risk factors in these patients at risk of developing liver cancer. “
From November 2015 to December 2016, researchers from the Barcelona Clinical Hospital enrolled patients with hepatitis C virus in their 12th week of SVR in the nurse-led liver cancer screening program with the aim of describe the habits of lifestyle changes as well as assess adherence to screening.
The study included 182 patients (median age, 69 years; 51.6% male) assessed at baseline and every 6 months until cancer diagnosis, death or loss of follow-up. The researchers used lifestyle change questionnaires, liver ultrasounds, laboratory tests, and anthropometric measurements for the assessment. Screening adherence was determined by comparing the theoretical number of liver ultrasounds and the actual number of ultrasounds the patient had undergone.
An increase in BMI was seen as early as 12 months and at all times, while an increase in waist-to-hip ratio was seen at 18 months in men and at 30 months in women.
“Regarding lifestyle changes, we observed a significant increase in the frequency of alcohol consumption in patients between 38 and 48 months of follow-up,” said Granel.
Physical activity was also reported to increase significantly between 6 and 30 months of follow-up while no change in coffee consumption was observed.
Adherence to the nurse-led liver cancer screening program was 96.7% at 1 year follow-up and over 80.2% after 4 years. During the 4 years of the screening program, eight patients developed hepatocellular carcinoma and 12 developed other types of cancer. The median time to development of HCC was 30.7 months, said Granel.
A change in lifestyle may explain the development of liver cancer observed during long-term follow-up, while strong adherence to the screening program may allow its diagnosis at early stages.
“Eradicating the hepatitis C virus does not eliminate the risk of developing liver cancer. Several factors are associated with it after obtaining a lasting neurological response, ”said Granel.