{
  "abstract": "Introduction Liver cancer is the fastest-rising cause of cancer related deaths in the UK. The most common form of primary liver cancer is hepatocellular carcinoma (HCC), which makes up 85% of all liver cancers. Patients with cirrhosis are at the highest risk to develop HCC, British Society of Gastroenterology and National Institute for Health and Care Excellence guidelines recommend 6-monthly US surveillance with/without AFP for such patients. Earlier detection provides greater opportunities for curative treatment and improved chances of survival. Despite clear guidelines, compliance with surveillance protocols is often sub-optimal in real world practice. This study aims to assess compliance rates for adherence to HCC surveillance guidelines.Methods We conducted a retrospective audit for 712 patients eligible for HCC surveillance in February 2024 at Swansea Bay University Health Board. Data was collected from clinical records of the cirrhotic patient to check if they had their 6 monthly USS according to the protocol. From the records we checked aetiology of cirrhosis, compliance for USS (Scan in the last 6 months), reasons for non-compliance, differences of compliance in different aetiology groups.Results A total of 712 patients were assessed for HCC surveillance across various liver disease aetiologies NAFLD/NASH (186), Alcohol related Liver Disease (277), HBV & HCV (73, 71 respectively), PBC (29), AIH (32), PSC (4) and cirrhosis of unknown aetiologies were 40.Overall, 63.6% (453/712) were found to be compliant to the surveillance. Compliance rates in different liver diseases were NAFLD/NASH 72% (134/186), alcohol related liver disease 62% (172/277), HCV 54.9% (39/71), HBV 43.8% (32/73), PBC 79.3% (23/29), AIH 71.8% (23/32), PSC 75% (3/4) and others 67.5% (27/40). Among 259 non-compliant patients, main reason for non-compliance was due to no request available for 117 (45.1%) and Did Not Attend/non-engagement in 97 patients (37.4%). An additional 11 patients have moved out of area, 24 were unsuitable for surveillance, 5 declined and 5 were unknown.Abstract P58 Figure 1Discussion Though the compliance for the HCC surveillance with Ultrasound scans in our study was comparatively better than those mentioned in the literature, there is further room for improvement. The compliance is affected by service related and patient related factors, for eg., aetiology of cirrhosis. We propose better database management, requesting USS on time and reminders sent to patients by texts to improve compliance. Our trust has moved to electronic requests and reporting which we hope will improve this further.",
  "authors": [
    {
      "affiliations": [
        "Swansea Bay University Health Board, Swansea, UK"
      ],
      "name": "Sachi Jain"
    },
    {
      "affiliations": [
        "Swansea Bay University Health Board, Swansea, UK"
      ],
      "name": "Louise Evans"
    },
    {
      "affiliations": [
        "Swansea Bay University Health Board, Swansea, UK"
      ],
      "name": "Praveen Eadala"
    },
    {
      "affiliations": [
        "Swansea Bay University Health Board, Swansea, UK"
      ],
      "name": "Jagadish Nagaraj"
    }
  ],
  "title": "P58 Barriers in hepatocellular carcinoma surveillance: A real-world assessment from a district general hospital",
  "uid": "d32b084e-86e9-5d25-a937-768eb65998d6"
}