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RecruitingNCT07010198Updated Jun 8, 2025

Head-to-Head Comparison of Hepatocellular Cancer (HCC) Screening Strategies: A Prospective Population-Based Cohort Study in Zhongshan City

An observational study in Hepatocellular Cancer (HCC), sponsored by Zhongshan People's Hospital, Guangdong, China. Recruiting at 1 site in China. Open to participants aged 35 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-06-08.

Sponsored by Zhongshan People's Hospital, Guangdong, China · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
4,500
Ages
35 Years and older
Sex
All
01

Study summary

Based on the preliminary retrospective validation of the efficacy of five HCC screening strategies(including conventional AFP combined with ultrasound-based general screening strategy, REACH-B, AGED, aMAPand aMAP 3.0 risk score) in Xiaolan Town, a head-to-head comparison for HCC screening is conducted in Zhongshan City, Guangdong Province. The study is a prospective, single-center, head-to-head trial aiming to enroll 4,500 HBsAg-positive individuals. It adopts a two-phase design of "HBV screening first, followed by HCC surveillance":Phase I: Recruitment of age-eligible populations at study sites for HBsAg screening to establish a high-risk cohort positive for hepatitis B surface antigen.Phase II: Implementation of uniform HCC surveillance (AFP combined with liver ultrasound every six months) for HBsAg-positive individuals, with concurrent application of different risk stratification models to evaluate risk levels and screening efficacy for each participant during follow-up.Furthurmore, based on baseline biological information and follow-up data, the study also aims to explore the development of a more effective risk prediction model for HCC.

02

Conditions studied

  • Hepatocellular Cancer (HCC)

Keywords

  • Screening
  • Hepatocellular Cancer
  • aMAP
03

Who can participate

Ages eligible
35 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Local household-registered residents aged ≥35 years, HBsAg-positive, with no prior diagnosis of HCC, residing in Zhongshan City.

Inclusion criteria

  • Voluntarily sign the informed consent form.
  • Household registration in Zhongshan City, Guangdong Province.
  • Aged 35 and above.
  • Positive screening result for Hepatitis B surface antigen (HBsAg).

Exclusion criteria

Exclusion Criteria:

  • Previous history of liver cancer or liver transplantation.
  • Pregnant women.
  • Severe comorbidities (e.g., end-stage cardiopulmonary diseases, advanced malignancies).
  • Individuals lacking legal capacity or unable to provide informed consent.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
4,500 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • HCC Screening Dynamic Cohort

    Local household-registered residents aged 35-64 years who are HBsAg-positive and have not been diagnosed with HCC prior to enrollment, residing in the study site communities of Zhongshan City

    Diagnostic Test: Quantitative HBeAg Testing · Biological: Measurement Indicators Required for Risk Scoring in HCC Screening Strategies · Biological: Follow-Up Monitoring Parameters

Interventions

  • Diagnostic testQuantitative HBeAg Testing

    Quantitative HBeAg Testing in Population-Based Primary Screening

  • BiologicalMeasurement Indicators Required for Risk Scoring in HCC Screening Strategies

    REACH-B: Age, Sex, HBeAg status, ALT levels, and HBV DNA load; AGED: Age, Sex, HBeAg status, HBV DNA load; aMAP: Age, Sex, Albumin, Total Bilirubin, Platelet Count; aMAP 3.0: Age, Sex, Albumin, Total Bilirubin, Platelet Count, AFP and PIVKA-II.

  • BiologicalFollow-Up Monitoring Parameters

    AFP, Liver Ultrasound

05

What researchers measure

Primary outcomes

  1. Incidence of HCC

    The number of newly diagnosed HCC cases divided by total person-years at risk during follow-up for each screening strategy.

    Time frame: 3 years

  2. Predictive performance (Sensitivity, Specificity, Positive Predictive value, AUC, etc.)

    Sensitivity, specificity, positive predictive value(PPV) and area under the ROC curve (AUC) will be calculated to evaluate the discrimination of each model.

    Time frame: 3 years

  3. Risk stratification accuracy

    Participants will be categorized into different risk strata (high, intermediate, low) by each model, and their observed HCC incidence will be compared to assess stratification accuracy.

    Time frame: 3 years

Secondary outcomes

  1. Screening positivity and referral rate

    Proportion of participants identified as medium/high-risk and referred for further diagnostic imaging (e.g.,pathology/CT/MRI).

    Time frame: 3 years

  2. Stage distribution of HCC cases identified by different screening strategies

    Time frame: 3 years

  3. Early detection rate of HCC cases identified by different screening strategies

    Time frame: 3 years

  4. Number Needed to Screen (NNS)

    Number of individuals needed to be screened to prevent one case of HCC.

    Time frame: 3 years

  5. Incremental Cost-Effectiveness Ratio (ICER)

    The additional cost required to gain one extra QALY or to prevent one HCC case using a given model, compared with baseline strategy.

    Time frame: 3 years

  6. Time-dependent AUC or C-index

    Model discrimination assessed at different time points using time-dependent ROC curves and concordance index (C-index).

    Time frame: 3 years

  7. Model performance in subgroups

    Subgroup analyses to compare predictive performance of each model in different populations (e.g., by sex, age, ALT level, HBV DNA level).

    Time frame: 3 years

  8. Overall survival (OS)

    Indicates whether the participant was alive at the end of follow-up and their survival duration.

    Time frame: 3 years

  9. Screening adherence

    The proportion of participants who completed biannual AFP and ultrasound screenings as scheduled during follow-up.

    Time frame: 3 years

06

Study locations

1 of 1 sites recruiting
  • Zhongshan People's Hospital
    Zhongshan, Guangdong 528403, China
    Recruiting
07

Registry details

Key details

Study ID
NCT07010198
Lead sponsor
Zhongshan People's Hospital, Guangdong, China
Responsible party
Mingfang Ji (Clinical Professor, Zhongshan People's Hospital, Guangdong, China) — Principal investigator
First posted
Jun 8, 2025
Start date
Mar 1, 2025
Primary completion
Dec 31, 2025 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Jun 8, 2025

Study contacts

Mingfang Ji, MD
Contact
jmftbh@sina.com
86-0760-89880417

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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