title: Physician-Patient Communication is Associated With Hepatocellular Carcinoma Screening in Chronic Liver Disease Patients.
abstract: Patients with chronic liver disease are at high risk for developing liver cancer. Factors associated with screening awareness and doctor-patient communication regarding liver cancer were examined.
  
  
  
  Four hundred sixty-seven patients with chronic liver disease at a tertiary-care clinic participated in a phone survey regarding awareness of cancer screening, doctor-patient communication, and health behaviors. Medical records were retrospectively reviewed for data on liver disease etiology and dates of liver imaging tests.
  
  
  
  Seventy-nine percent of patients reported awareness of liver cancer screening, and 50% reported talking to their doctor about liver cancer. Patients with higher education, abstinence from alcohol, and liver cirrhosis were more likely to be aware of liver cancer screening (P=0.06, 0.005, <0.0001). Whites, patients with higher education, and those with cirrhosis were more likely to talk to their doctor about liver cancer (P=0.006; P=0.09, <0.0001). Awareness of liver cancer screening (79%) was similar to that of colorectal cancer screening (85%), lower than breast cancer screening (91%), and higher than prostate cancer screening (66%). Patients who were aware of liver cancer screening and reported talking to their doctor about liver cancer were significantly more likely to receive consistent liver surveillance (odds ratio, 4.81; 95% confidence interval, 2.62-8.84 and odds ratio, 1.97; 95% confidence interval, 1.19-3.28, respectively).
  
  
  
  Our study demonstrates the importance of effective physician communication with chronic liver disease patients on the risks of developing liver cancer and the importance of regular screening, especially among nonwhites and patients with lower education.
authors.affiliation: *Department of Surgery, Division of Public Health Sciences †Department of Surgery, Section of Abdominal Transplantation, School of Medicine ‡Division of Biostatistics, School of Medicine, Washington University in St. Louis, MO.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Li
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Neeta
authors.initials: N
authors.lastname: Vachharajani
authors.forename: Wint Yan
authors.initials: WY
authors.lastname: Aung
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Garonzik-Wang
authors.forename: William C
authors.initials: WC
authors.lastname: Chapman
mesh_terms: D001741:Black or African American; D000368:Aged; D001291:Attitude of Health Personnel; D001364:Awareness; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology; D002908:Chronic Disease; D003142:Communication; D055088:Early Detection of Cancer / Q000379:methods*; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D008019:Life Style; D008107:Liver Diseases / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D044465:White People