Survey study of clinician-level knowledge and barriers to hepatocellular carcinoma surveillance in the USA

Surveillance for hepatocellular carcinoma (HCC) in patients with cirrhosis is underused in the USA. A survey study evaluated clinician-level factors contributing to this underuse. In this study of 347 primary care, gastroenterology, and hepatology clinicians across 5 US safety-net health systems, gaps in HCC surveillance knowledge were observed, particularly among primary care clinicians. Perceived barriers and challenges to HCC surveillance use were identified, including health system factors contributing to persisting delay in timely HCC surveillance despite 3 years after the onset of the COVID-19 pandemic. The authors conclude that these findings suggest that improved HCC education and health system-level interventions must be pursued in parallel to address the complex barriers contributing to suboptimal HCC surveillance.