Hepatocellular carcinoma (HCC) screening rates among cirrhosis patients in safety-net health systems were already low before COVID-19 — and they've only gotten worse. A new JAMA Network Open study found semiannual surveillance dropped from 30.8% pre-pandemic to just 22.3% post-pandemic, with no signs of recovery. Uninsured and indigent care patients fared worst, with fewer than 1 in 8 receiving recommended screening.
Liver cancer screening was already in trouble before COVID-19 hit — and the pandemic made things significantly worse. A new study published in JAMA Network Open found that only about 1 in 5 adults with cirrhosis in U.S. safety-net health systems received guideline-recommended hepatocellular carcinoma (HCC) surveillance, and rates have continued to decline even years after the pandemic's peak.
Researchers analyzed data from 6,940 cirrhosis patients across five safety-net systems over three time periods. Semiannual HCC surveillance — recommended every 6 months by liver disease guidelines — dropped from 30.8% pre-COVID to 21.1% during the pandemic, and only marginally recovered to 22.3% post-pandemic. Annual surveillance rates followed a similar downward trend. Uninsured and indigent care patients saw continued declines even in the post-pandemic period, with fewer than 12% receiving any surveillance.
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Why it matters: Early detection is critical for HCC outcomes — the cancer is far more treatable when caught at an early stage. With screening rates stagnant and the most vulnerable patients falling furthest behind, researchers are now calling for targeted, practical interventions tailored to safety-net populations to close a gap that COVID only deepened.
