通过直接作用抗病毒 (DAA) 疗法治愈丙型肝炎病毒 (HCV) 后，肝细胞癌 (HCC) 的风险会随着时间的推移而下降。肝脏学会指南建议对这些患者继续进行 HCC 筛查，但缺乏筛查结果的数据。旨在评估 HCV 治愈后 HCC 筛查与总体生存率的关系。这项队列研究评估了在退伍军人事务部医疗保健系统于 2014 年 1 月至 2022 年 12 月期间进行。数据分析于 2023 年 10 月至 2024 年 1 月期间进行。按照随访年份和 HCC 诊断前 4 年计算最新进行建议的 HCC 筛查所花费的时间百分比（可检测的无症状阶段）。主要结局是 HCC 诊断后的总生存期，并通过使用 Kaplan-Meier 分析和 Cox 比例风险回归进行筛查所花费的时间百分比进行比较。诊断和治疗时的早期 HCC 是使用逻辑回归评估的次要结果。 总共纳入了 16902 名个体（中位 [IQR] 年龄，64.0 [60.5-67.4] 岁；16426 名男性 [97.2%]），其中第 1622 章从随访第 1 年到第 7 年，HCC 的累积发病率从 2.4%（16902 人中的 409 人）下降至 1.0%（2833 人中的 27 人）。在 HCC 诊断前 4 年中至少 50% 的时间进行最新筛查与改善总体生存率相关（各层平等的对数秩检验 P = .002）。在多变量分析中，截至目前筛查的随访时间每增加 10%，死亡风险就会降低 3.2%（风险比，0.97；95% CI，0.95-0.99）。 HCV 治愈后的时间与筛查之间存在统计学上显着的交互作用，但在 HCV 治愈后 5 年以上被诊断为 HCC 的患者中没有观察到相关性。最新筛查每花费 10% 的时间，诊断出早期 HCC 的可能性就会增加 10.1%（95% CI，6.3%-14.0%），治愈性治疗的可能性就会增加 6.8%（95% CI）。 ，2.8%-11.0%）。在这项针对 HCV 相关肝硬化患者的队列研究中，他们实现了 HCV 治愈并随后发展为 HCC，及时进行筛查与改善总体生存率相关，支持对符合条件的个体进行筛查。

The risk of hepatocellular carcinoma (HCC) declines over time after hepatitis C virus (HCV) cure by direct-acting antiviral (DAA) therapies. Liver society guidelines recommend continuing HCC screening for these patients, but data on screening outcomes are lacking.To evaluate the association of HCC screening after HCV cure with overall survival.This cohort study evaluated patients with HCV cirrhosis who achieved DAA-induced HCV cure in the Veterans Affairs health care system between January 2014 and December 2022. Data analysis occurred from October 2023 to January 2024.The percentage of time spent up to date with recommended HCC screening was calculated by year of follow-up and during the 4 years preceding HCC diagnosis (the detectable asymptomatic phase).The primary outcome was overall survival after HCC diagnosis and was compared by percentage of time spent up to date with screening using Kaplan-Meier analyses and Cox proportional hazards regression. Early-stage HCC at diagnosis and curative treatment were secondary outcomes assessed using logistic regression.A total of 16 902 individuals were included (median [IQR] age, 64.0 [60.5-67.4] years; 16 426 male [97.2%]), of whom 1622 developed HCC. The cumulative incidence of HCC declined from 2.4% (409 of 16 902 individuals) to 1.0% (27 of 2833 individuals) from year 1 to year 7 of follow-up. Being up to date with screening for at least 50% of time during the 4 years preceding HCC diagnosis was associated with improved overall survival (log-rank test of equality over strata P = .002). In multivariate analysis, each 10% increase in follow-up spent up to date with screening was associated with a 3.2% decrease in the hazard of death (hazard ratio, 0.97; 95% CI, 0.95-0.99). There was a statistically significant interaction between time since HCV cure and screening, with no association observed among those who received a diagnosis of HCC more than 5 years after HCV cure. Each 10% of time spent up to date with screening was associated with a 10.1% increased likelihood of diagnosis with early-stage HCC (95% CI, 6.3%-14.0%) and a 6.8% increased likelihood of curative treatment (95% CI, 2.8%-11.0%).In this cohort study of persons with HCV-related cirrhosis who achieved HCV cure and subsequently developed HCC, remaining up to date with screening was associated with improved overall survival, supporting the screening of eligible individuals.