title: Controlling liver cancer internationally: A qualitative study of clinicians' perceptions of current public policy needs.
abstract: BACKGROUND
  Liver cancer is the fifth most common cancer in men and the seventh for women. Usually because of late diagnosis, the prognosis for liver cancer remains poor, resulting in liver cancer being the third most common cause of death from cancer. While some countries have treatment guidelines, little is known or understood about the strategies needed for liver cancer control internationally.
  
  
  OBJECTIVE
  To explore leading liver cancer clinician's perceptions of the current public policy needs to control liver cancer internationally.
  
  
  METHODS
  Key informant interviews were conducted with a range of liver cancer clinicians involved in policy in eleven countries. Interviews were digitally recorded, transcribed verbatim, translated (where necessary), de-identified and analyzed by two researchers using a constant comparative method.
  
  
  RESULTS
  Twenty in-depth semi-structured interviews were conducted in: Australia, China, France, Germany, Italy, Japan, Spain, South Korea, Taiwan, Turkey and the United States. Nine themes were identified and cluster into three groups: 1) Promoting prevention via early risk assessment, focusing on viral hepatitis and other lifestyle factors; 2) Increasing political, public and medical community awareness; and 3) Improving funding for screening, liver cancer surveillance and treatment.
  
  
  CONCLUSIONS
  This study is an important step towards developing an evidence-based approach to assessing preparedness for implementing comprehensive liver cancer control strategies. Evaluation mechanisms to assess countries' performance on the needs described are needed. Future research will concentrate of understanding how these needs vary across countries and the optimal strategies to improve the diagnosis and prognosis of patients with liver cancer internationally.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. ggallego@jhsph.edu.
authors.forename: John Fp
authors.initials: JF
authors.lastname: Bridges
authors.forename: Gisselle
authors.initials: G
authors.lastname: Gallego
authors.forename: Barri M
authors.initials: BM
authors.lastname: Blauvelt