Jean-Luc Szpakowski, MD

Gastroenterology, Greater Southern Alameda Area

“Dr. Szpakowski’s study provides invaluable evidence for all clinicians caring for patients with HBV.”

Dr. Jean-Luc Szpakowski had a question that needed an answer. Did young people with hepatitis B virus (HBV) infection really need extensive testing for liver cancer (HCC)? “I’d see people with HBV in their 20s and 30s getting multiple ultrasounds and high radiation CT scans looking for liver cancer and I thought, people that age almost never get liver cancer,’” says Dr. Szpakowski.

His study, Causes of Death in Patients With Hepatitis B: A Natural History Cohort Study in the United States, published in Hepatology (2013) confirmed that it was extremely rare for any man younger than 40 or a woman under the age of 50 to die of liver disease.

The study showed that for older patients, the risk of dying from cirrhosis and HCC increased with age. What was unexpected, however, was that the risk rose so much that even in old age it was the cause of death in over 40% of all patients with HBV, more than heart disease and all other cancers combined. His findings strongly indicated that, in his words, “age appropriate screening for HCC is the most important cancer screening these patients can get.”