Table 3.
Provider knowledge, attitudes, and barriers towards HBV management and liver cancer screening
| Knowledge (mean score = 8.5 ± 1.76) | Correct Answers (%) |
|---|---|
| Chronic hepatitis B is often asymptomatic | 97% |
| The majority of the world’s population live in hepatitis B-endemic areas | 74% |
| Screening for liver cancer among hepatitis B patients is cost-effective | 64% |
| Vaccination against hepatitis B can prevent liver cancer | 95% |
| Treating hepatitis B can prevent cirrhosis | 90% |
| Uninfected household contacts of hepatitis B carriers do not need to receive hepatitis B vaccination | 92% |
| High levels of hepatitis B viral load are associated with increased risk of cirrhosis | 67% |
| In patients with hepatitis B, liver cancer only occurs in the setting of cirrhosis | 71% |
| All patients with hepatitis B should be treated | 62% |
| The prevalence of chronic hepatitis B remains high in this country due to high rates of acute hepatitis B | 72% |
| The balance of risks and benefits associated with liver cancer screening in patients with chronic hepatitis B are clearly known | 28% |
| Attitudes (mean score = 5.5 ± 1.71) | Percent Agree |
| What factors influence you to order screening tests? | |
| When there is good evidence that screening leads to decreased mortality | 97% |
| When it is recommended by a national organization | 92% |
| When I see an increased frequency of that disease in my population | 72% |
| When my patients ask for it | 64% |
| When it is used as a quality measure at my institution or by insurance companies | 78% |
| When it is covered by health insurance | 62% |
| Not screening for liver cancer among patients with hepatitis B is a malpractice risk | 65% |
| There are mostly other factors | 58% |
| Perceived Barriers (mean score = 1.26 ± 1.35) | Percent Agree |
| Difficulty accessing specialty (GI/Hepatology) care | 26% |
| Language barriers with patient | 9% |
| Patient financial barriers | 15% |
| Lack of blood testing resources | 1% |
| Lack of clarity of liver cancer screening guidelines | 25% |
| Uncertain or unaware of liver cancer screening guidelines | 24% |
| Discomfort with discussing liver cancer screening | 1% |
| Lack of effective treatment for liver cancer | 9% |
| Other barriers (listed by provider) | 16% |