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Table 1 Themes and dimensions

From: Controlling liver cancer internationally: A qualitative study of clinicians' perceptions of current public policy needs

Theme

Dimension

 

Promoting prevention

Viral hepatitis

"You really need to work backwards in the spectrum of the disease so you are detecting more early disease and either curing Hep C or preventing Hep B both of which will eventually lead to a decreased incidence of HCC".

 

Early risk assessment

"We need to go out and identify at-risk patients, encourage them to be screened, and linked them to appropriate care".

 

Other risk factors

"Part of the problem is that the prevalence of obesity continues to rise, it may have leveled off now, but until now it has been rising precipitously so that there will presumably be a lag period during which patients who are obese and then over time they will accrue a risk of liver or fibrosis and cancer".

Increase awareness

Political awareness

"...on a national basis the government has no strict plan for HCC and this is a big issue".

 

Clinical education

"Primary care doctors need to be sensitized to the risk of liver disease, the implications, the detection in particular of viral hepatitis, the treatment options, and the need to refer, and ultimately screening for liver cancer"

 

Public awareness

"There is a total absence of public awareness as best as I can tell. I am not there with my finger on the pulse of the public, but it's fairly clear that this never gets on the radar the way breast, colon, melanoma, pancreas, and other common cancers do".

Improve funding

Screening

"There's a clear need for screening of cirrhotic patients. Screening is expensive......".

 

Treatments

"...the new and expensive drugs and technologies are an exception. So many patients complain, many patients ask for a new technology or a newly developed drug and treatment. However they are not covered by insurance, so that's a big problem".

 

Surveillance

"a more concerted effort to coordinate with [Ministry of Health] and to develop more robust prevalence data about viral hepatitis worldwide".