Screening for Hepatocellular Carcinoma by Egyptian Physicians

Background: Hepatocellular Carcinoma (HCC) is the fifth most common malignancy in the world complicating liver cirrhosis in most cases. Aim of the Work: To assess the practice of Egyptian physicians in screening patients for HCC. Study Population and Methods: The study included 154 physicians from all over Egypt caring for patients at risk for HCC. The study was based on a questionnaire with 20 items. Each questionnaire consisted of two parts: (1) Personal information regarding the physician (name, age, specialty and type of health care setting); (2) Professional experience in the care of patients at risk for HCC development (screening, knowledge about the cause and natural course of liver diseases and HCC risk). Results: 68% of doctors with an MD degree, 48% of doctors with a master degree or a diploma and 40% of doctors with a Bachelor of Medicine, Bachelor of Surgery (MB BCh) certificate considered the HCV genotype as risk factor for HCC development (p 0.05). Ninty percent of physicians specialized in tropical medicine, internal medicine or gastroenterology and 67% of physicians in other specialties advise patients to undergo screening for HCV and HBV infection as well as liver cirrhosis (p 0.05). 86% of doctors in University Hospitals and 69% of MOH doctors consider HCV infection as the leading cause of HCC in Egypt (p 0.05). 72% of doctors with an MD degree, 55% of doctors with a master degree or a diploma, 56% of doctors with an MBBCH certificate, 74% of doctors in University Hospitals and 46% of MOH hospital doctors consider abdominal Ultrasonography (US) as the most important investigation in HCC screening (p 0.05). 65% of physicians in tropical medicine, internal medicine or gastroenterology and 37% of physicians in other specialties recommend as HCC screening interval of 3 months (p 0.05). 71% of doctors with an MD degree, 50% of doctors with a master degree or diploma and 60% of doctors with an MBBCH certificate follow the same recommendation. Conclusions: In Egypt, physicians specialized in tropical medicine, internal medicine or gastroenterology with an MD degree and working in a University Hospital are best informed about HCC.