HJBR Nov/Dec 2022

50 NOV / DEC 2022 I  HEALTHCARE JOURNAL OF BATON ROUGE ONCOLOGY has the ability for queries and automated or- ders that could potentially standardize the screening process, reducing the need for human interaction. Given the severity and significance of this disease, it is time we used the available technology to its fuller potential to address a disease that desperately needs attention and action. n REFERENCES 1 Davila, J.A.; Morgan, R.O.; Richardson, P.A.; et al. “Use of surveillance for hepatocellular carci- noma among patients with cirrhosis in the United States.” Hepatology 52, no. 1. (July 2010): 132-41. doi: 10.1002/hep.23615 2 Yang, J.D.; Mannalithara, A.; Piscitello, A.J.; et al. “Impact of surveillance for hepatocellular car- cinoma on survival in patients with compensated cirrhosis.” Hepatology 68, no. 1 (July 2018): 78-88. doi: 10.1002/hep.29594 3 Zhang, B.H.; Yang, B.H.; Tang, Z.Y. “Randomized controlled trial of screening for hepatocellular carcinoma.” Journal of Cancer Research and Clini- cal Oncology 130, no. 7 (July 2004): 417-422. doi: 10.1007/s00432-004-0552-0 4 Singal, A.G.; Pillai, A.; Tiro, J. “Early detection, curative treatment, and survival rates for hepa- tocellular carcinoma surveillance in patients with cirrhosis: a meta-analysis.” PLoS Medicine 11, no. 4 (Apr. 1, 2014): e1001624. doi: 10.1371/journal. pmed.1001624 5 Marrero, J.A.; Kulik, L.M.; Sirlin, C.B., et al. “Diag- nosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the Ameri- can Association for the Study of Liver Diseases.” Hepatology 68, no. 2 (August 2018): 723-750. doi: 10.1002/hep.29913 6 European Association for the Study of the Liver. “EASL Clinical Practice Guidelines: Management of Hepatocellular Carcinoma.” Journal of Hepatol- ogy 69, no. 1 (July 2018): 182-236. doi: 10.1016/j. jhep.2018.03.019. 7 Burak, K.W.; Sherman, M. “Hepatocellular carci- noma: Consensus, controversies and future direc- tions. A report from the Canadian Association for the Study of the Liver Hepatocellular Carcinoma Meeting.” Canadian Journal of Gastroenterology and Hepatology 29, no. 4. (May 2015): 178-84. doi: 10.1155/2015/824263 8 Omata, M.; Cheng, A.L.; Kokudo, N., et al. “Asia- Pacific clinical practice guidelines on the manage- ment of hepatocellular carcinoma: a 2017 update.” Hepatol International 11, no. 4 (July 2017): 317-370. doi: 10.1007/s12072-017-9799-9 9 Sarasin, F.P.; Giostra, E.; Hadengue, A. “Cost- effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosis.” American Journal of Medicine 101, no. 4 (October 1996): 422-434. doi: 10.1016/S0002-9343(96)00197-0 10 He, D.; Xu, W.; Su H.; et al. “Electronic health Re- cord-Based screening for major cancers: A 9-year experience in Minhang district of Shanghai, China.” Frontiers in Oncology 9 (May 22, 2019): 375. doi: 10.3389/fonc.2019.00375 John M. Lyons, III, MD, FACS, FSSO is a fellowship- trained surgical oncologist. His practice focuses ex- clusively on treating cancer patients.He believes that treating cancer is a team sport, and communication with patients and other doctors is essential. Lyons was the first surgeon in Louisiana to performa major hepatectomy (liver resection) for cancer using a completely robotic surgical approach. He currently chairs the hepaticopancreaticobiliary (HPB) disease teamat the Our Lady of the Lake Cancer Institute and, through this team,started the first high-risk pancreas cancer screening program in the state of Louisiana. Also, Lyons is clinical associate professor for the LSU Department of Surgery and has recently been ap- pointed chairman of theAmerican College of Surgeons Commission on Cancer for the State of Louisiana. the authors used their EMR to identify study patients by medical diagnoses, by their previ- ous exposures/behavioral patterns (e.g., ex- cessive sunlight, asbestos, smoking, etc.) as well as their family oncologic history. Patients were further identified by their location and access to hospital care. These “high risk” pa- tients identified by the EMRwere then offered education on cancer screening and preven- tion, and they were encouraged enrollment in a free checkup programdesigned at targeting rural residents. Physicians were prompted by the EMR with automatic reminders to screen these patients at regular intervals. These au- thors found that use of the EMR in this way identified 12%more cancers at a significantly earlier stage than had been previously noted. Screening cirrhotic patients using ultra- sound and bloodwork increases survival from liver cancer. This not only provides a public health benefit, but it also increases the cost effectiveness of healthcare delivery. However, screening for liver cancer remains woefully underutilized and explains (at least partially) why most liver cancer patients in our state present with such advanced disease. The EMR houses thousands of patient data- points that can be used to help busy provid- ers identify patients who meet criteria for liver cancer screening. Additionally, the EMR Organizations with screening guidelines for Liver Cancer • American Association for the Study of Liver Diseases (AASLD) • American Gastroenterological Association (AGA) • National Comprehensive Cancer Network (NCCN) • American College of Gastroenterology (ACG) • European Assoc. for the Study of the Liver (EASL)–EORTC • European Society for Medical Oncology (ESMO) • American Society of Clinical Oncology (ASCO) • American Gastroenterological Association (AGA) • Canadian Association for the Study of the Liver (CASL) • Asian Pacific Association for the Study of the Liver (APASL) • Japan Society of Hepatology (JSH) • Spanish Society of Medical Oncology • Spanish Association for Study of the Liver (AEEH)