Comparing Predicted Probability of Hepatocellular Carcinoma in Patients With Cirrhosis With the General Population: An Opportunity to Improve Risk Communication?


Innes, Hamish, Hamill, Victoria, McDonald, Scott A, Hayes, Peter C, Johnson, Philip ORCID: 0000-0003-1404-0209, Dillon, John F, Bishop, Jen, Yeung, Alan, Went, April, Barclay, Stephen T et al (show 4 more authors) (2022) Comparing Predicted Probability of Hepatocellular Carcinoma in Patients With Cirrhosis With the General Population: An Opportunity to Improve Risk Communication? AMERICAN JOURNAL OF GASTROENTEROLOGY, 117 (9). pp. 1454-1461.

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Abstract

<h4>Introduction</h4>Risk scores estimating a patient's probability of a hepatocellular carcinoma (HCC) diagnosis are abundant but are difficult to interpret in isolation. We compared the predicted HCC probability for individuals with cirrhosis and cured hepatitis C with the general population (GP).<h4>Methods</h4>All patients with cirrhosis achieving sustained viral response (SVR) in Scotland by April 2018 were included (N = 1,803). The predicted 3-year probability of HCC at time of SVR achievement was determined using the aMAP prognostic model. GP data on the total number of incident HCCs in Scotland, stratified by demographics, were obtained from Public Health Scotland. Predicted HCC risk of cirrhosis SVR patients was compared with GP incidence using 2 metrics: (i) incidence ratio: i.e., 3-year predicted probability for a given patient divided by the 3-year probability in GP for the equivalent demographic group and (ii) absolute risk difference: the 3-year predicted probability minus the 3-year probability in the GP.<h4>Results</h4>The mean predicted 3-year HCC probability among cirrhosis SVR patients was 3.64% (range: 0.012%-36.12%). Conversely, the 3-year HCC probability in the GP was much lower, ranging from &lt;0.0001% to 0.25% depending on demographics. The mean incidence ratio was 410, ranging from 5 to &gt;10,000. The mean absolute risk difference was 3.61%, ranging from 0.012% to 35.9%. An online HCC-GP comparison calculator for use by patients/clinicians is available at https://thrive-svr.shinyapps.io/RShiny/ .<h4>Discussion</h4>Comparing a patient's predicted HCC probability with the GP is feasible and may help clinicians communicate risk information and encourage screening uptake.

Item Type: Article
Uncontrolled Keywords: Humans, Hepatitis C, Chronic, Carcinoma, Hepatocellular, Liver Neoplasms, Liver Cirrhosis, Antiviral Agents, Incidence, Risk Factors, Communication, Sustained Virologic Response
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 30 May 2023 10:01
Last Modified: 30 May 2023 10:01
DOI: 10.14309/ajg.0000000000001879
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3170732
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