Study Questions Cancer Screening for Those With Cirrhosis From Alcoholism

July 30, 2012

Presently, the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver recommend cancer screenings for patients living with alcoholic liver damage. Each of these organizations advocates that cirrhosis patients get screened for liver cancer every six months. The medical costs for this can start to add up quickly depending on health insurance coverage and what is found during the initial ultrasound.

Of course, if the risk for liver cancer is high in cirrhosis patients, these costs would be well worth it, however, a new study from Denmark published in the Annals of Internal Medicine is saying that the screenings may be unnecessary because the cancer threat is low. This may be why the US Preventive Services Task Force, a panel of independent experts that analyze current scientific research to provide guidelines on preventive therapies, does not currently endorse cancer screenings for cirrhosis.

Danish Study Finds Risk for Liver Cancer After Cirrhosis Doesn’t Justify Screening

Roughly 8,500 patients in Denmark admitted to the hospital for cirrhosis of the liver due to excessive alcohol consumption were analyzed for risk of developing liver cancer. Researchers found that the chance of being diagnosed with liver cancer within five years for these patients was less than 1 percent. That statistic falls beneath the 1.5 percent recommended by the US guidelines for cost-effectiveness. What is more, the results showed that of all the patients who passed during the study period, only 2 percent of the deaths were related to liver cancer. These findings indicate preventative liver cancer screenings for alcoholic cirrhosis patients may cost far more than they are worth.

Past Studies Suggested Liver Cancer Risk Was Higher

Numerous prior studies on this topic worldwide have advocated the preventative liver cancer screenings after finding a much larger percentage of risk for liver cancer than the Danish study did. For example, one French study found a rate of 5 percent a year for liver cancer developing after cirrhosis caused by alcoholism. The Danish research team believes the discrepancy in findings is due to the sample of patients used. The subjects in older studies were patients undergoing treatment in hospitals, whereas the Danish study was retrospective using health information on all individuals between 1993 and 2005 who had an initial hospitalization for alcoholic cirrhosis.

Do you think any risk warrants preventative screening, or that the money and number of lives saved need to be taken into account? Tell us your thoughts below.