The effect of COVID-19 on the diagnosis of HCC
| Category | Main findings |
|---|---|
| Diagnosis of HCC in medical centers | HCC diagnoses in Italy fell in 2020 by 20% vs. 2018 and 2019 (from an average of 2.5 to 2 cases) [16] and fell in 2020 by 30.4% vs. 2018 and 2019 (from an average of 46 to 32 cases) [17] New HCC cases declined 26.7% during the pandemic vs. the pre-pandemic [18] The number of first diagnoses in patients affected by HCC declined (221 in 2020 vs. 304 in 2019) [19], and decreased over the weeks in 2020 but not in 2019 (P = 0.034), and the first diagnosis of HCC decreased (P = 0.083) [19] The number of new HCC cases declined 29% during the lockdown period in 2018, 2019, and 2020 (from 450 and 398 to 303) [20], and declined 9% after the lockdown period in 2018, 2019, and 2020 (from 513 and 522 to 469) [20] The average number of new diagnoses of liver and intrahepatic bile duct cancer declined 34.13% in the early phase of COVID-19 in 2020 vs. 2019 (from 13.8 cases to 9.09 cases per 100,000 patients with healthcare encounters) [21], and declined 25.58% in the late phase of COVID-19 in 2020 vs. 2019 (from 11.49 cases to 8.55 cases per 100,000 patients with healthcare encounters) [21] The number of new HCC diagnoses was equal two times (n = 14 vs. 14) [22] |
| Activities of diagnostic centers and pathology laboratories | The percentage of liver samples increased from 0.14% to 0.27% (P < 0.05) [23] Liver samples number decreased from 158 to 98 samples (P < 0.05) [23] The number of HCC diagnoses from February 1 to March 15, 2020 vs. 2018 and 2019 decreased from 80 and 27 to 15 cases [24], and from March 16 to April 30, 2020 vs. 2018 and 2019 decreased from 15 and 20 to 14 cases [24] The percentage of HCC diagnoses on February 1 to March 15, 2020 vs. 2018 and 2019 changed from 5.4% and 17.5% to 7.7% [24], and from March 16 to April 30, 2020 vs. 2018 and 2019 increased from 9.9% to 16.7% [24] In pre-COVID-19 2020 vs. during COVID-19 in 2020, the number of HCC diagnoses decreased from 15 cases to 14 cases [24], and % of HCC diagnoses increased from 7.7% to 16.7% [24] Cases discussed in MDTM 4.3% increase in 2020 vs. 82/555 (15%) in 2019 [25] HCC new diagnosis: 69/579 (12%) in 2020 vs. 82/555 (15%) in 2019 [25] |
| Delay in diagnosis | In BCLC 0/A/B recorded 48.2% and in BCLC C reported 51.9% [18] |
| Screening method | The screening program was changed in 80.9% of centers in the first wave of the COVID-19 pandemic [26] Biopsy and imaging technology requests were modified by 4.8% during the COVID-19 pandemic [26] The MR/CT acquisition strategy for HCC staging or assessment of response to treatment has been altered by 39.5% [26] |
| Risk of HCC in patients with alcohol-related hepatitis | HCC occurrence increased in the post-COVID group: OR = 1.19; 95% CI, 1.08–1.32; P < 0.001 [27] |
MDTM: multidisciplinary team meeting; BCLC: Barcelona Clinic Liver Cancer; MR/CT: magnetic resonance/computed tomography; OR: odds ratio; CI: confidence interval
