Exploring Gaps in Disease Knowledge and Surveillance Practices in Cirrhotic Patients: A Cross- Sectional Study
DOI:
https://doi.org/10.47489/szmc.v40i2.958Keywords:
Carcinoma, Hepatocellular, Liver Cirrhosis, Liver Neoplasms, Biomarkers, TumorAbstract
Background: Hepatocellular carcinoma (HCC) is the fifth most common tumor in the world. It is also the third leading cause of cancer-related deaths worldwide. Therefore, global liver societies recommend HCC surveillance every 6 months in individuals who are at high risk of developing HCC.
Objective: To study the disease awareness in our population and their adherence to surveillance for HCC.
Methods: This is a cross sectional study which was conducted in the Gastroenterology department of the Aga Khan University Hospital from May 2025 to October 2025. Adult patients with Child class A or B cirrhosis were enrolled to complete an anonymous self-administered survey. A structured questionnaire was adapted from previously published and validated studies assessing knowledge, attitude, and practice (KAP) regarding hepatocellular carcinoma surveillance. The tool was reviewed by a panel of gastroenterology experts for content validity. It was translated into Urdu using forward and backward translation to ensure linguistic accuracy. A pilot study was conducted on a small subset of patients to assess clarity and feasibility. Internal consistency was evaluated using Cronbach’s alpha, which demonstrated acceptable reliability. Clinical data was retrieved from electronic health records.
Results: A total of 150 patients completed the survey. The median age was 56 years (IQR 49–65). Most patients belonged to an urban and educated population (69%). Most common cause of cirrhosis was HCV (35.3%), followed by Non B Non C (34%) and then HBV (30.7%). Only 56.7% patients underwent 6 monthly surveillances. Most patients did not have appropriate knowledge regarding their disease or importance of hepatocellular carcinoma surveillance. More than 90% patients desired more information from their healthcare professional. Factors that contributed most as barrier towards surveillance were residing in rural areas, lack of education and financial status. (p value <0.001).
Conclusion: Enhancing patient awareness and addressing barriers to surveillance are essential for effective HCC prevention in cirrhotic patients. Targeted interventions are required to improve adherence to 6 monthly surveillance guidelines to prevent morbidity and mortality from HCC.
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