Randomized controlled trial of screening for hepatocellular carcinoma
N = 18,816
- Population
- People aged 35-59 years in urban Shanghai with hepatitis B virus infection or a history of chronic hepatitis.
- Design
- Randomised controlled trial in urban Shanghai, China. 18,816 people aged 35-59 years with hepatitis B virus infection or a history of chronic hepatitis were randomly allocated to screening or control (the abstract does not state whether the unit of randomisation was individual or group). The screening group was invited for an AFP test and ultrasonography every 6 months; screening stopped in December 1997 (five to ten offers per participant) and follow-up ended in December 1998. Controls received no screening.
- Primary endpoint
- Liver cancer mortality
- Arms
- Screening group (experimental, n = 9,373): AFP test and ultrasonography every 6 months
- Control group (control, n = 9,443): No screening; usual use of health-care facilities
- People
- Zhang BH
Δ Resection among HCC cases+39 pointsΔ 12-month Survival after HCC diagnosis+34.7 points
Show the numbers
| Endpoint | Analysis | Screening group | Control group | Effect |
|---|---|---|---|---|
| Resection among HCC casesPeople with HCC in each group (86 screening, 67 control), as listed in the abstract | exploratoryZhang 2004 | 46.5% | 7.5% | Resection in 40 of 86 versus 5 of 67 (counts as published). Subclinical HCC: 52 (60.5%) in the screening group and none in controls; small HCC: 39 (45.3%) versus none. |
| Survival after HCC diagnosisPeople with HCC in each group (86 screening, 67 control), as listed in the abstract | exploratoryZhang 2004 | 65.9% at 12 mo; 52.6% at 3 y; 46.4% at 5 y | 31.2% at 12 mo; 7.2% at 3 y; 0% at 5 y | Survival rates are listed in the abstract among the cancers diagnosed in each group, not among all people randomised; the abstract does not define the denominator or give confidence intervals. |
| Endpoint | Analysis | Screening group | Control group | Effect |
|---|---|---|---|---|
| Resection among HCC casesPeople with HCC in each group (86 screening, 67 control), as listed in the abstract | exploratoryZhang 2004 | 46.5% | 7.5% | Resection in 40 of 86 versus 5 of 67 (counts as published). Subclinical HCC: 52 (60.5%) in the screening group and none in controls; small HCC: 39 (45.3%) versus none. |
| Survival after HCC diagnosisPeople with HCC in each group (86 screening, 67 control), as listed in the abstract | exploratoryZhang 2004 | 65.9% at 12 mo; 52.6% at 3 y; 46.4% at 5 y | 31.2% at 12 mo; 7.2% at 3 y; 0% at 5 y | Survival rates are listed in the abstract among the cancers diagnosed in each group, not among all people randomised; the abstract does not define the denominator or give confidence intervals. |