HJBR Nov/Dec 2022

48 NOV / DEC 2022 I  HEALTHCARE JOURNAL OF BATON ROUGE ONCOLOGY DIALOGUE COLUMN ONCOLOGY CANCER SCREENING saves lives. This has been evident for decades. In fact, the first suc- cessful cancer screening test in the modern era was described by George Papanicolaou, DO, in 1928. Today, we know that his “Pap” smear has reduced the mortality rate from cervical cancer by over 80% and has made what was once an overwhelming public health nightmare into a very treatable con- dition. Screening has also been proven ef- fective for breast, colon, prostate, and lung cancers. This knowledge is largely known to the American public and has been strongly embraced by healthcare providers. Less known, however, is that liver cancer can also be screened for. Studies have dem- onstrated that when screening is performed in appropriate individuals, the efficacy rates for liver cancer screening are just as good as those for breast, colon, prostate, and lung cancer. Moreover, just like breast, colon, and lung cancer, when liver cancer is detected early, curative therapies — like surgical resec- tion and transplantation — allow for excellent long-term survival. However, liver cancer in the United States is usually found at an ad- vanced stage, when the survival rates are almost always dismal. In Louisiana, the situation is even worse. The bayou state ranks No. 2 in the country in liver cancer mortality, and the median cancer-specific survival for all patients di- agnosed with liver cancer in Louisiana is less than one year. Moreover, this problem is not going away any time soon as the incidence of liver cancer in the U.S. tripled between 1980 and 2015. The major risk factor for the development of liver cancer is the presence of cirrhosis. Cirrhosis is influenced by several factors including viral hepatitis, diabetes, heavy al- cohol consumption, and obesity. These risk factors are all in great abundance in Louisi- ana, and this partially explains why the bayou state is such a hotbed for this disease. While there are many public health initiatives cur- rently addressing the problem of liver cancer, a major concern, in the opinion of this author, is the underutilization of liver cancer screen- ing. Standard screening recommendations for liver cancer include a noninvasive abdominal ultrasound — a test far less invasive than a colonoscopy and far less expensive than a low dose CT scan — along with a single blood Using the Electronic Medical Record to Reduce Mortality from Liver Cancer