Retrospective cohort study of hepatocellular carcinoma screening in a contemporary cohort of at-risk patients

Cohort studies demonstrating an association of hepatocellular carcinoma (HCC) screening with reduced mortality are prone to lead-time and length-time biases. In a retrospective cohort study of 1313 HCC patient, only 42.3% of cases were detected by screening. Detection by screening was associated with improved early-stage detection and survival, which persisted after adjusting for lead-time bias and for length-time biases. The authors conclude that HCC screening is associated with reduced mortality, even after accounting for biases, and remains an important target for interventions to increase utilization.