Hepatitis B and hepatocellular carcinoma screening among Asian Americans: Survey of safety net healthcare providers

Mandana Khalili, Jennifer Guy, Albert Yu, Alexander Li, Nadia Diamond-Smith, Susan L Stewart, Moon S Chen, Tung Nguyen

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Physician patterns of screening for hepatitis B (HBV) and hepatocellular carcinoma (HCC) among Asian Americans are not well described. Aims: To describe HBV and HCC screening practices among providers with large Asian American populations. Methods: Providers within San Francisco's safety net system were surveyed with respect to HBV and HCC screening practices as well as knowledge, attitudes, and barriers to HCC screening. Results: Among the 109 respondents (response rate = 72%), 62% were aged >40, 65% female, 24% Asian, 87% primary care providers, and 48% had >25% Asian patients. Only 76% had screened >50% of their Asian patients for HBV and 43% had vaccinated >50% of eligible patients against HBV. Although 94% knew Asians were disproportionately affected by HCC, only 79% had screened for HCC in >50% of their Asian patients with chronic hepatitis B (CHB). A majority believed that HCC screening in CHB reduces HCC mortality (70%) and is cost-effective (57%). The most common HCC screening modality was AFP with abdominal ultrasound every 6-12 months (63%). Factors associated with HBV screening were familiarity with AASLD guidelines (OR 6.4, 95% CI 1.3-30.1, p = 0.02) and having vaccinated >50% of eligible patients against HBV (OR 2.2, 95% CI 1.1-4.5, p = 0.03). Factors associated with HCC screening using abdominal ultrasound every 6-12 months were having >25% Asian patients (OR = 4.5, 95% CI 1.3-15.3, p = 0.02) and higher HCC knowledge score (OR = 1.9 per item, 95% CI 1.01-3.6, p = 0.045). Conclusions: HBV and HCC screening rates and HBV vaccination among Asians from physician report is suboptimal. HCC screening is associated with having more Asian patients and higher provider knowledge. Provider education is essential in increasing rates of HBV and HCC screening among Asian Americans.

Original languageEnglish (US)
Pages (from-to)1516-1523
Number of pages8
JournalDigestive Diseases and Sciences
Volume56
Issue number5
DOIs
StatePublished - May 2011

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Safety-net Providers
Asian Americans
Hepatitis B
Health Personnel
Hepatocellular Carcinoma
Chronic Hepatitis B
Surveys and Questionnaires
Physicians
San Francisco

Keywords

  • Asian American
  • Hepatitis B screening
  • Hepatocellular carcinoma surveillance
  • Provider practices

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Hepatitis B and hepatocellular carcinoma screening among Asian Americans : Survey of safety net healthcare providers. / Khalili, Mandana; Guy, Jennifer; Yu, Albert; Li, Alexander; Diamond-Smith, Nadia; Stewart, Susan L; Chen, Moon S; Nguyen, Tung.

In: Digestive Diseases and Sciences, Vol. 56, No. 5, 05.2011, p. 1516-1523.

Research output: Contribution to journalArticle

Khalili, Mandana ; Guy, Jennifer ; Yu, Albert ; Li, Alexander ; Diamond-Smith, Nadia ; Stewart, Susan L ; Chen, Moon S ; Nguyen, Tung. / Hepatitis B and hepatocellular carcinoma screening among Asian Americans : Survey of safety net healthcare providers. In: Digestive Diseases and Sciences. 2011 ; Vol. 56, No. 5. pp. 1516-1523.
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abstract = "Background: Physician patterns of screening for hepatitis B (HBV) and hepatocellular carcinoma (HCC) among Asian Americans are not well described. Aims: To describe HBV and HCC screening practices among providers with large Asian American populations. Methods: Providers within San Francisco's safety net system were surveyed with respect to HBV and HCC screening practices as well as knowledge, attitudes, and barriers to HCC screening. Results: Among the 109 respondents (response rate = 72{\%}), 62{\%} were aged >40, 65{\%} female, 24{\%} Asian, 87{\%} primary care providers, and 48{\%} had >25{\%} Asian patients. Only 76{\%} had screened >50{\%} of their Asian patients for HBV and 43{\%} had vaccinated >50{\%} of eligible patients against HBV. Although 94{\%} knew Asians were disproportionately affected by HCC, only 79{\%} had screened for HCC in >50{\%} of their Asian patients with chronic hepatitis B (CHB). A majority believed that HCC screening in CHB reduces HCC mortality (70{\%}) and is cost-effective (57{\%}). The most common HCC screening modality was AFP with abdominal ultrasound every 6-12 months (63{\%}). Factors associated with HBV screening were familiarity with AASLD guidelines (OR 6.4, 95{\%} CI 1.3-30.1, p = 0.02) and having vaccinated >50{\%} of eligible patients against HBV (OR 2.2, 95{\%} CI 1.1-4.5, p = 0.03). Factors associated with HCC screening using abdominal ultrasound every 6-12 months were having >25{\%} Asian patients (OR = 4.5, 95{\%} CI 1.3-15.3, p = 0.02) and higher HCC knowledge score (OR = 1.9 per item, 95{\%} CI 1.01-3.6, p = 0.045). Conclusions: HBV and HCC screening rates and HBV vaccination among Asians from physician report is suboptimal. HCC screening is associated with having more Asian patients and higher provider knowledge. Provider education is essential in increasing rates of HBV and HCC screening among Asian Americans.",
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T1 - Hepatitis B and hepatocellular carcinoma screening among Asian Americans

T2 - Survey of safety net healthcare providers

AU - Khalili, Mandana

AU - Guy, Jennifer

AU - Yu, Albert

AU - Li, Alexander

AU - Diamond-Smith, Nadia

AU - Stewart, Susan L

AU - Chen, Moon S

AU - Nguyen, Tung

PY - 2011/5

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N2 - Background: Physician patterns of screening for hepatitis B (HBV) and hepatocellular carcinoma (HCC) among Asian Americans are not well described. Aims: To describe HBV and HCC screening practices among providers with large Asian American populations. Methods: Providers within San Francisco's safety net system were surveyed with respect to HBV and HCC screening practices as well as knowledge, attitudes, and barriers to HCC screening. Results: Among the 109 respondents (response rate = 72%), 62% were aged >40, 65% female, 24% Asian, 87% primary care providers, and 48% had >25% Asian patients. Only 76% had screened >50% of their Asian patients for HBV and 43% had vaccinated >50% of eligible patients against HBV. Although 94% knew Asians were disproportionately affected by HCC, only 79% had screened for HCC in >50% of their Asian patients with chronic hepatitis B (CHB). A majority believed that HCC screening in CHB reduces HCC mortality (70%) and is cost-effective (57%). The most common HCC screening modality was AFP with abdominal ultrasound every 6-12 months (63%). Factors associated with HBV screening were familiarity with AASLD guidelines (OR 6.4, 95% CI 1.3-30.1, p = 0.02) and having vaccinated >50% of eligible patients against HBV (OR 2.2, 95% CI 1.1-4.5, p = 0.03). Factors associated with HCC screening using abdominal ultrasound every 6-12 months were having >25% Asian patients (OR = 4.5, 95% CI 1.3-15.3, p = 0.02) and higher HCC knowledge score (OR = 1.9 per item, 95% CI 1.01-3.6, p = 0.045). Conclusions: HBV and HCC screening rates and HBV vaccination among Asians from physician report is suboptimal. HCC screening is associated with having more Asian patients and higher provider knowledge. Provider education is essential in increasing rates of HBV and HCC screening among Asian Americans.

AB - Background: Physician patterns of screening for hepatitis B (HBV) and hepatocellular carcinoma (HCC) among Asian Americans are not well described. Aims: To describe HBV and HCC screening practices among providers with large Asian American populations. Methods: Providers within San Francisco's safety net system were surveyed with respect to HBV and HCC screening practices as well as knowledge, attitudes, and barriers to HCC screening. Results: Among the 109 respondents (response rate = 72%), 62% were aged >40, 65% female, 24% Asian, 87% primary care providers, and 48% had >25% Asian patients. Only 76% had screened >50% of their Asian patients for HBV and 43% had vaccinated >50% of eligible patients against HBV. Although 94% knew Asians were disproportionately affected by HCC, only 79% had screened for HCC in >50% of their Asian patients with chronic hepatitis B (CHB). A majority believed that HCC screening in CHB reduces HCC mortality (70%) and is cost-effective (57%). The most common HCC screening modality was AFP with abdominal ultrasound every 6-12 months (63%). Factors associated with HBV screening were familiarity with AASLD guidelines (OR 6.4, 95% CI 1.3-30.1, p = 0.02) and having vaccinated >50% of eligible patients against HBV (OR 2.2, 95% CI 1.1-4.5, p = 0.03). Factors associated with HCC screening using abdominal ultrasound every 6-12 months were having >25% Asian patients (OR = 4.5, 95% CI 1.3-15.3, p = 0.02) and higher HCC knowledge score (OR = 1.9 per item, 95% CI 1.01-3.6, p = 0.045). Conclusions: HBV and HCC screening rates and HBV vaccination among Asians from physician report is suboptimal. HCC screening is associated with having more Asian patients and higher provider knowledge. Provider education is essential in increasing rates of HBV and HCC screening among Asian Americans.

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KW - Hepatocellular carcinoma surveillance

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