Screening of hepatocellular carcinoma in patients with uncomplicated cirrhosis in real life: Practices survey of general practionners from three towns of Seine-Saint-Denis (north-east suburb of Paris)

摘要

Cirrhosis is a frequent and severe pathology life threatening, due to the occurrence of complications including hepatocellular carcinoma. In order to assess the degree of conformity, of practices, with the French guidelines for the surveillance of patients with compensated cirrhosis and the primary prevention of complications, published in 2007, all general practitioners practicing in three towns from north-east suburb of Paris (Seine-Saint-Denis) representing a population pool of 186 286 inhabitants were asked during the first quarter of 2012 for the face-toface administration of a standardized questionnaire. Based on the 20 questions, individual practices were analyzed and a compliance score limited to hepatocellular carcinoma screening was established. Of the 106 practitioners surveyed, 40 have agreed to participate (85% of men, mostly based in Aulnay-sous-Bois or Sevran with an average exercice of 22 years). The declared practices were heterogeneous and did insuffisantly comply with the recommendations (mean score 1.9/3). The intent of surveillance was not influenced by the origin or severity of cirrhosis. Screening for HCC was based on appropriate tests (abdominal ultrasound, alpha-foetoprotein serum) but with optimal half-yearly intervals in less than half of the cases. Improved communication to general private practitioners of HAS recommendations for patients with compensated cirrhosis could optimize the prescribing of screening tests for hepatocellular carcinoma.