Despite advances in cancer screening, care and survival, hepatocellular carcinoma (HCC) remains unabated and is one of the most common malignant tumors worldwide and leads to high mortality. It is well-known that chronic hepatitis B infection (HBV) is a major risk factor for HCC. Despite the presence of recommendations from the American Association for the Study of Liver Diseases (AASLD) on performing periodic HCC screening, little is known about the screening strategies employed by primary care physicians PCPs) and hepatologists for HBV patients within the United States and in the community setting. Because the incidence of HCC occurs at a greater rate in Asians, this pilot study will target and identify patterns and processes of HBV care within the Asian American community. The study hypotheses are: 1) HBV infected patients who receive care from hepatologists are more likely to be screened in accordance to current AASLD guideline than those who receive care from PCPs, 2) HCC screening is related to patient factors such as age, gender, and cirrhosis as well as provider specialty and years in practice; and 3) HBV infected individuals who are screened for HCC are more likely to have early stages of HCC and therefore undergo therapeutic interventions. To test these hypotheses, we propose to study the following Aims: 1) to describe current HCC screening practices among PCP and hepatologists with large Asian American patient populations, 2) to assess provider and patient factors associated with HCC screening, and 3) to identify the proportion of HCC screened population who underwent therapeutic interventions as compared to HCC unscreened population. This project represents a community-based participatory research effort. Results of this pilot study will provide a baseline understanding of the current HCC screening strategies that is practiced within a community setting. Dissemination and input from Asian American health community providers and advocates will also be part of the future work plan to improve HBV care in San Francisco and community organizations that focuses on reducing cancer health disparities amongst the Asian community. Data collection and analytical results of this study will help provide a basis for identifying gaps in clinical medical education training of management of chronic HBV infected patient population. In addition, this grant will assist in the career development plan of the project leader, Dr. Khalili; allowing her to establish ongoing collaborative research effort with the community and a reputation as a local expert in HBV care. Furthermore, the data gained from this project will serve as the preliminary data for further applications. ? ? ?
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