Screening, early diagnosis and treatment of liver cancer in Zherong county of Fujian province: 2012 – 2019

  Objective  To examine outcomes of screening, early diagnosis and treatment of liver cancer in Fujian province and to provide evidences for the evaluation on population-based liver cancer screening.

  Methods   Zherong county in a mountainous rural region of the province was selected with cluster sampling for the analysis. Serum hepatitis B virus surface antigen (HBsAg) was tested among all male residents aged 35 – 64 years and female residents aged 45 – 64 years in diagnostic screenings on liver cancer carried out from July 2012. Then serum alpha-fetoprotein (AFP) detection and B-mode ultrasonography (BU) of liver were performed in all HBsAg-positive residents every 6 months after the screening. All diagnosed liver cancer patients were followed up till April 30th, 2021 and observed survival of the patients were calculated with life table method. The efficiency of the screening, early diagnosis and treatment were assessed using rate of task completion, detection, early diagnosis, and early treatment.

  Results  Of 51 486 residents having HBsAg screening from July 2012 through December 2019, 4 412 (8.72%) were positive. Among the HBsAg-positive participants, 10 653 person-times of AFP detection and BU of liver were carried out, with an overall task completion rate of 94.16%, and totally 49 liver cancer cases were detected, with the detection rate of 0.32%. For all the diagnosed liver cancer cases, the rate of early detection was 40.81% and that of early treatment was 79.59%. The calculated 1-, 3-, 5-year survival of the liver cancer cases were 75.51%, 43.28%, and 34.96% and the survivals were significantly higher than those of 36.18%, 16.56%, and 11.60% for the liver cancer patients registered from 2012 through 2014 in Fujian Provincial Cancer Registry System (P < 0.05 for all).

  Conclusion  The study findings suggest that semiannual serum AFP detection and BU of liver could detect liver cancer cases more effectively in HBsAg-positive population and the survival of the detected liver cases may be increased due to early diagnosis and treatment.