Pandemic-Related Disruptions and Hepatocellular Carcinoma Surveillance in Safety-Net Settings

Were the COVID-19 pandemic disruptions associated with declines in hepatocellular carcinoma (HCC) surveillance among patients with cirrhosis?In this cohort study of 6940 patients with cirrhosis across 5 US safety-net health systems, 30.8% underwent guideline-recommended HCC surveillance within 6 months after diagnosis from March 1, 2018, to February 29, 2020. Following onset of the COVID-19 pandemic (March 1, 2020, to February 28, 2022), HCC surveillance declined to 21.1% and did not rebound, remaining at 22.3% from March 1, 2022, to February 29, 2024.These findings suggest that among US safety-net populations with cirrhosis, pandemic-related declines in HCC surveillance remained even up to 4 years after the onset of the COVID-19 pandemic, with fewer than 1 in 4 patients undergoing guideline-concordant HCC surveillance.

Corresponding Author: Robert J. Wong, MD, MS, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 3801 Miranda Ave, Palo Alto, CA 94304 (rwong123@stanford.edu).

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