Hepatocellular carcinoma

摘要

Alejandro Forner and colleagues (March 31, p 1245)1 advocate for screening of hepatocellular carcinoma despite no evidence of benefit, arguing that a "validation trial in developed regions is not feasible".Only two randomised trials are available, both from China: one is negative, the other is positive but has several major flaws.2 From developed countries, only observational studies are available. These conclude that screening improves survival despite the raw data showing that screened patients die younger than do non-screened patients (length time and lead time biases).