## Abstract

BACKGROUND:

Risk scores estimating a patient’s probability of a hepatocellular carcinoma (HCC) diagnosis are abundant, but are difficult to interpret in isolation. Here, we compared the predicted HCC probability for individuals with cirrhosis and cured hepatitis C to the general population (GP).

METHODS:

All patients with cirrhosis achieving sustained viral response (SVR) in Scotland by April 2018 were included (N=1803). The predicted three-year probability of HCC at time of SVR achievement was determined using the aMAP prognostic model. GP data on the total number of incident HCCs in Scotland, stratified by demographics, were obtained from Public Health Scotland.

Predicted HCC risk for cirrhosis SVR patients was compared to GP incidence using two metrics: 1) Incidence ratio: i.e. three-year predicted probability for a given patient divided by the three-year probability in GP for the equivalent demographic group; and 2) Absolute risk difference: the three-year predicted probability minus the three-year probability in the GP).

RESULTS:

The mean predicted three-year HCC probability among cirrhosis SVR patients was 3.64% (range: 0.012%-36.12%). Conversely, the three-year HCC probability in the GP was much lower, ranging from 10,000. The mean absolute risk difference was 3.61%, ranging from 0.012 to 35.9%. An online HCC-GP comparison calculator for use by patients/clinicians is available at: https://thrive-svr.shinyapps.io/RShiny/Comparing a patient’s predicted HCC probability to the general population is feasible and may help clinicians communicate risk information and encourage screening uptake.

Risk scores estimating a patient’s probability of a hepatocellular carcinoma (HCC) diagnosis are abundant, but are difficult to interpret in isolation. Here, we compared the predicted HCC probability for individuals with cirrhosis and cured hepatitis C to the general population (GP).

METHODS:

All patients with cirrhosis achieving sustained viral response (SVR) in Scotland by April 2018 were included (N=1803). The predicted three-year probability of HCC at time of SVR achievement was determined using the aMAP prognostic model. GP data on the total number of incident HCCs in Scotland, stratified by demographics, were obtained from Public Health Scotland.

Predicted HCC risk for cirrhosis SVR patients was compared to GP incidence using two metrics: 1) Incidence ratio: i.e. three-year predicted probability for a given patient divided by the three-year probability in GP for the equivalent demographic group; and 2) Absolute risk difference: the three-year predicted probability minus the three-year probability in the GP).

RESULTS:

The mean predicted three-year HCC probability among cirrhosis SVR patients was 3.64% (range: 0.012%-36.12%). Conversely, the three-year HCC probability in the GP was much lower, ranging from 10,000. The mean absolute risk difference was 3.61%, ranging from 0.012 to 35.9%. An online HCC-GP comparison calculator for use by patients/clinicians is available at: https://thrive-svr.shinyapps.io/RShiny/Comparing a patient’s predicted HCC probability to the general population is feasible and may help clinicians communicate risk information and encourage screening uptake.

Original language | English |
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Journal | American journal of gastroenterology |

Early online date | 24 Jun 2022 |

DOIs | |

Publication status | E-pub ahead of print - 24 Jun 2022 |