A Bayesian screening approach for hepatocellular carcinoma using multiple longitudinal biomarkers

A Bayesian screening approach for hepatocellular carcinoma using multiple longitudinal biomarkers IntroductionIn the United States, the incidence of hepatocellular carcinoma (HCC) has tripled over the last two decades, while the 5‐year survival of patients with HCC has remained largely unchanged at <12% (El‐Serag, ). Patients with early stage HCC have multiple treatment options and the 5‐year survival for treated patients exceeds 60% (Bruix and Sherman, ). Five‐year survival for HCC cases that are diagnosed at a later (symptomatic) stage is between 0 and 10%. Early detection of HCC through surveillance is critical to reducing mortality.The target population for HCC surveillance are those patients with cirrhosis, since 80–90% of HCC cases occur in patients with cirrhosis. Six‐month ultrasonography is recommended (Bruix and Sherman, ), however, there is disagreement over the benefit of surveillance. In the United States, the majority of surveillance ultrasounds are performed at local hospitals with variable quality because ultrasonography is operator dependent, not sensitive in detecting early lesions and difficult to perform in obese patients. Serum α‐Fetoprotein (AFP) is a diagnostic HCC biomarker widely used to complement ultrasonography. The reported sensitivity for AFP varies between 41 and 100% and specificity between 70 and 95% in both diagnostic and screening settings and across a range of study designs (Gebo http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Biometrics Wiley

A Bayesian screening approach for hepatocellular carcinoma using multiple longitudinal biomarkers

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018, The International Biometric Society
ISSN
0006-341X
eISSN
1541-0420
D.O.I.
10.1111/biom.12717
Publisher site
See Article on Publisher Site

Abstract

IntroductionIn the United States, the incidence of hepatocellular carcinoma (HCC) has tripled over the last two decades, while the 5‐year survival of patients with HCC has remained largely unchanged at <12% (El‐Serag, ). Patients with early stage HCC have multiple treatment options and the 5‐year survival for treated patients exceeds 60% (Bruix and Sherman, ). Five‐year survival for HCC cases that are diagnosed at a later (symptomatic) stage is between 0 and 10%. Early detection of HCC through surveillance is critical to reducing mortality.The target population for HCC surveillance are those patients with cirrhosis, since 80–90% of HCC cases occur in patients with cirrhosis. Six‐month ultrasonography is recommended (Bruix and Sherman, ), however, there is disagreement over the benefit of surveillance. In the United States, the majority of surveillance ultrasounds are performed at local hospitals with variable quality because ultrasonography is operator dependent, not sensitive in detecting early lesions and difficult to perform in obese patients. Serum α‐Fetoprotein (AFP) is a diagnostic HCC biomarker widely used to complement ultrasonography. The reported sensitivity for AFP varies between 41 and 100% and specificity between 70 and 95% in both diagnostic and screening settings and across a range of study designs (Gebo

Journal

BiometricsWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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