Healthcare providers require training on resources for hepatocellular carcinoma surveillance

Primary care clinicians are facing challenges in understanding and implementing hepatocellular carcinoma (HCC) tracking and surveillance resources, according to a recent study published in JAMA Network Open. The research, led by Dr. Robert Wong from Stanford University, revealed gaps in HCC surveillance knowledge, particularly among primary care clinicians, even three years after the onset of the COVID-19 pandemic.

The study found that HCC surveillance is underused in patients with cirrhosis, with ultrasound being the primary imaging modality for liver surveillance. Factors contributing to this underuse include a lack of diagnostic radiology resources. The researchers conducted a survey study involving 347 primary care clinicians, as well as gastroenterology and hepatology clinicians from five safety-net health systems in the U.S.

Results showed that while 77.1% of gastroenterology and hepatology clinicians scored five or more questions correctly on an HCC knowledge exam, only 45.8% of primary care clinicians achieved the same score. Primary care clinicians were more likely to report barriers such as inadequate time to discuss HCC surveillance, difficulty identifying patients with cirrhosis, and not being up to date with surveillance guidelines.

The study authors emphasized the need for targeted education and health system-level interventions to improve HCC surveillance. These interventions could include radiology recall systems, electronic medical record dashboards, reminder systems, and organized health-system-level outreach strategies.

Overall, the findings underscore the importance of addressing barriers to HCC surveillance to ensure timely monitoring of patients with cirrhosis. The full study can be accessed for further details on this critical issue.