Perspectives of physicians regarding screening patients at risk of hepatocellular carcinoma

Methods: Three hundred physicians from three academic centers were invited to participate in a mailed survey questionnaire. The main outcome measure was physicians' knowledge of the current HCC screening guidelines. Demographic and clinical variables were obtained from the survey questionnaire. Results: A total of 177 (59.0%) out of the 300 invited physicians responded to the survey questionnaire, including faculty members (n = 129), residents (n = 46), and fellows (n = 2). The specialty areas of the responding physicians were internal medicine (62.1%), family medicine (16.4%), gastroenterology (15.3%), oncology (3.4%) and others (2.8%). The number of physicians who performed HCC screening in patients with cirrhosis secondary to chronic hepatitis B and chronic hepatitis C infection were 163 (92.1%) and 167 (94.4%), respectively; 35.0% of them used alpha-fetoprotein (AFP) every 6 months, while 22.0% used imaging modalities every 6 months to screen for HCC. Further, 22 physicians (12.4%) did not check for serum AFP levels and 33 (18.6%) never used imaging to screen for HCC. Conclusion: The majority of the participating physicians screen high-risk patients for HCC. However, the most appropriate modality of screening (i.e. imaging) is not employed by most physicians and there is greater reliance on AFP levels.