We thank Dr. Braillon for his comments. Although most evidence in the literature suggest that HCC screening is beneficial [1, 2], we agree that there are limitations to the available data on hepatocellular carcinoma (HCC) screening as indicated in our paper [3]. We also agree that sources of bias such as lead time and length time bias will need to be excluded when assessing the impact of screening modalities. As indicated by Dr. Braillon, practice of evidence-based medicine is of outmost importance; however, as randomized controlled trials (the highest quality evidence) of HCC screening in North America or Europe are unlikely to be feasible or possible [4], current guidelines established by the American [2], European [5] and Asian [6], and other societies recommending HCC screening are based on lesser degrees of evidence.
展开▼
