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Louise Henderson, PhD, is an established researcher who has impactfully applied epidemiology research to produce evidence-based information on performance, access, surveillance, disparities and outcomes of breast and lung cancer screening across North Carolina. As long-time Principal Investigator of the Carolina Mammography Registry (CMR), one of seven National Breast Cancer Surveillance Consortium mammography registries, Dr. Henderson is a nationally recognized expert in translating data collected from partnering breast imaging facilities across North Carolina into data-driven tools useful to stakeholders whose work relates to advancing breast cancer screening practices.

Well-timed to the concerning rise in incidence and rates of hepatocellular carcinoma (HCC) mortality across North Carolina, Dr. Henderson’s population-based screening expertise was tapped in early 2021 for a collaborative study of HCC disease surveillance patterns statewide. Dr. Henderson has teamed up with UNC Division of Gastroenterology and Hepatology Fellow Andrew Moon, MD, MPH, who studies HCC, shortcomings in hepatology screening tests and other areas of clinical interest.

In January 2021, Drs. Moon and Henderson were awarded a Lineberger Comprehensive Cancer Center (LCCC) $150K development grant for a two-year, pre-pilot project entitled, “Improving hepatocellular carcinoma screening among cirrhosis patients from North Carolina using lab-based risk stratification tools.” Beginning in March 2021 (3/1/2021 – 2/28/2023), the School of Medicine collaborators (Moon: contact P.I / Henderson: co-P.I.) will investigate factors driving low utilization of HCC surveillance across North Carolina with serial ultrasound +/- serum alpha-fetoprotein in patients with cirrhosis, for whom HCC surveillance is recommended.

Through prescribing direct acting antivirals (DAAs), providers can treat and cure Hepatitis C virus (HCV), a leading cause of HCC and cirrhosis. Such disease management of HCV-cured patients can overlook evaluation for cirrhosis, however, resulting in missed HCC surveillance opportunities. HCC risk stratification models that utilize standard of care HCV lab results should improve the identification of HCV patients at risk of HCC and increase HCC surveillance rates.

Over two years, Moon and Henderson will assess current HCC surveillance practices across North Carolina through validating existing lab-based HCC risk stratification tools among HCV-treated patients. Surveying community providers to assess attitudes and behaviors toward HCC surveillance will aid the investigators in identifying those interested in participating in a subsequent pilot to test using point-of-care HCC risk stratification tools.

Through data-driven results indicating how community care settings might incorporate HCC risk stratification tools in patient management, this feasibility study aims to assist community PCPs, gastroenterologists, public health leaders, researchers and other stakeholders across North Carolina in identifying high-risk patients for referral to active HCC screening programs, particularly in resource-limited areas.

Dr. Henderson noted: “This project builds upon my prior research evaluating population-based screening patterns and use of risk-based screening to optimize care in real world settings. I look forward to collaborating with Dr. Moon on this study given his clinical expertise in improving outcomes for patients with HCC and his ongoing research in this space.”

Dr. Moon stated: “This study will help us better understand hepatocellular carcinoma (HCC) screening practices in North Carolina. These novel lab-based risk stratification tools have the potential to improve HCC screening, particularly in resource-limited areas, which could help reduce existing disparities in the screening, diagnosis and treatment of HCC.

I am excited to work with Dr. Henderson, who is a national expert in cancer screening and outcomes. Her extensive expertise in improving breast and lung cancer screening practices will be vital as we assess the feasibility of incorporating point-of-care risk stratification tools to improve HCC screening practices across the state.”


PHOTOS: Professor of Radiology Louise Henderson, PhD / Division of Gastroenterology and Hepatology Fellow Andrew Moon, MD, MPH