| In Korea, HCC is the 5th most common cancer and 2nd highest cause of cancer death. The National Liver Cancer Screening Program for HCC surveillance has been conducted in Korea since 2003. We investigated the impact of nationwide surveillance on the prognosis of chronic liver disease in Korea. This population-based cohort study from the Korean National Health Insurance Service included 2003 to 2015 claims data collected from 1,209,825 patients aged over 40 years with CHB, CHC, and LC. Patients were divided according to HCC surveillance using US and serum AFP every 6-12 months. The study outcomes were the receipt of curative treatment (surgical resection, RFA, or liver transplantation) and all-cause mortality. The study population consisted of 1,209,825 patients with CHB, CHC, and LC (median age, 52.0 years; male, 56.5%). The proportion of participants who underwent HCC surveillance was 52.7%. During follow-up, 74,433 HCC cases developed, including 36,006 patients who underwent curative treatment. The surveillance group had a significantly higher proportion of curative treatment for HCC than the non-surveillance group after adjusting for confounding factors (adjusted hazard ratio [HR], 5.64; 95% confidence interval [CI], 5.48-5.81). The surveillance group had a significantly lower mortality rate than the non-surveillance group (adjusted HR, 0.56; 95% CI, 0.55-0.56). HCC surveillance in Korea using the national screening program in patients with chronic viral hepatitis or liver cirrhosis provides better opportunity for curative treatment for HCC and improves overall survival. |
