| Objective: To analyze the results of a community?based liver cancer screening program targeting key populations in Jiading District, Shanghai, in 2024, and to provide evidence for optimizing screening strategies in real?world settings.Methods: Key populations at risk of liver cancer were identified through an information?system?based screening approach using multiple local health data platforms. Primary screening was performed at 13 community health service centers using a combination of abdominal ultrasound, serum alpha?fetoprotein (AFP), protein induced by vitamin K absence or antagonist?II (PIVKA?II), and the Gender?Age?AFP?DCP (GAAD score). Participants with positive screening results were referred to designated hospitals for confirmatory diagnosis and treatment. The screening outcomes were analyzed, and factors associated with positive primary screening were examined using the chi?square test and multivariate logistic regression.Results:A total of 12,013 high?risk individuals were enrolled through information?based screening. Primary screening was performed using a combined panel consisting of ultrasound, alpha?fetoprotein (AFP), protein induced by vitamin K absence or antagonist?II (PIVKA?II), and the GAAD score (Gender?Age?AFP?DCP Algorithm, a risk assessment model for liver cancer based on sex, age, AFP, and PIVKA?II). A total of 1,230 positive cases were identified, yielding a positivity rate of 10.24% (1,230/12,013). Overall, 16 liver cancer cases were confirmed, giving a detection rate of 0.13% (16/12,013), among which 75.00% (12/16) were diagnosed at early stages (CNLC stage Ia–IIa). Univariate analysis among screen?positive individuals showed that those with a history of cirrhosis, hepatitis B, or fatty liver disease had a significantly higher proportion of confirmed liver cancer. Multivariate logistic regression identified male sex, age ≥60 years, and a history of cirrhosis as independent factors associated with higher primary screening positivity.Conclusion: The primary screening positivity rate and the proportion of early?stage liver cancer diagnoses among the key population in Jiading District are relatively high. The information?system?based identification approach can streamline the screening workflow, and the combined panel of ultrasound, AFP, PIVKA?II, and the GAAD score may substantially improve the detection of early?stage liver cancer. Within the target population, males, individuals aged ≥60 years, and those with cirrhosis should be prioritized for enrollment. Among screen?positive participants, those with a history of cirrhosis, hepatitis B, or fatty liver disease represent key subgroups for focused intervention. |
