In 2023, VA will embark on a study to determine the most effective screening technique for liver cancer, a deadly cancer that can be cured if caught early. This is the largest clinical trial in history related to liver cancer screening.

The study will determine whether detecting liver cancer earlier with abbreviated MRI can make a difference for patients’ risk of death. The study is better known as PREMIUM—PREventing Liver Cancer Mortality through Imaging with Ultrasound vs. MRI. The trial’s objective is to determine whether screening with abbreviated magnetic resonance imaging is better than ultrasound.

Ultrasound is the current standard of care in reducing liver cancer deaths in Veterans.

“This type of large, multicenter trial could only be conducted in VA, the largest integrated health care system in the country,” said Dr. Carolyn M. Clancy, the assistant under secretary of Health for Discovery, Education and Affiliate Networks. “VA has a high prevalence of patients with advanced liver disease who could benefit from screening for liver cancer. The study has the potential to change clinical practice for tens of thousands of Veterans and non-Veterans alike. It could answer key questions about liver cancer screening that have been debated for more than three decades.”

This effort is a part of the Biden-Harris Administration’s Cancer Moonshot to care for those with cancer and end cancer as we know it. Liver cancer is the sixth leading cause of cancer-related death in the U.S. The PREMIUM trial will recruit 4,700 Veterans with cirrhosis (liver scarring caused by several different conditions) from 47 VA medical centers.

VA is the largest health care provider in the U.S. for patients with cirrhosis, a leading risk factor for liver cancer. Enrollment will begin in 2023 and follow participants over an 8-year period. This is the first clinical trial to compare the two screening methods (Ultrasound and MRI) for effect on patient death.

Ultrasound quality can vary

Ultrasound has long been the standard of care for liver cancer screening. Its quality can vary significantly depending on the person doing the procedure and the body type of the patient. MRI is the gold standard for detecting liver cancer once a mass is detected on ultrasound. Abbreviated MRI, a much shorter procedure than standard MRI, has shown promise in detecting liver cancer at early stages.

The trial is led by co-chairs Dr. George Ioannou of Puget Sound VA and Dr. Tamar Taddei of Connecticut VA, sponsored by the VA Cooperative Studies Program and coordinated by the West Haven CSP Coordinating Center.

For more information, visit the PREMIUM clinical trial site.

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12 Comments

  1. Steve Maieli December 29, 2022 at 08:30

    My father (Vietnam veteran) died due to liver cancer, which the VA denied his military service had anything to do with it.

    Yet, in this this article the VA wants to admit “VA is the largest health care provider in the U.S. for patients with cirrhosis, a leading risk factor for liver cancer.”

    So why is that?

    VA needs to take these results from this study and take a hard look at veterans military service and the effects it had on veterans livers especially Vietnam veterans who were around agent orange.

    About time the VA supports these veterans and stop denying them benefits , too many are dieing due to liver disease due to service in Vietnam who were exposed to agent orange like my father whose disabilities were listed under the agent orange registry, yet liver cancer does not exist.

    VA needs to think again and add Liver disease to the list before we lose more veterans waiting for a liver transplant like my father and son many of his brothers and sisters who served for this country that speaks about doing so much for us veterans.

    Liver disease/ cancer should be listed under agent orange list years ago, do the right thing VA!

  2. Charles M Virts December 28, 2022 at 23:47

    The radiologist that read my CT scan that I get yearly on my lungs, saw a spot on my liver that wasn’t there the previous year. Finding it early saved my life and I believe the great and thorough work by the doctor reading my CT scan was a lifesaver.

  3. Tracy Kawasaki December 28, 2022 at 23:14

    I was exposed to PCBs years ago while working in an Ohio ANG maintenance shop. We were all tested for PCBs. Everyone else got a result of of negative for PCB poisoning. My results were “inconclusive”. A couple of years ago, My gall bladder went toxic and had to be removed. The surgeons report said I had fatty deposits on my liver. The surgeon then referred me for alcohol counseling. I drink sparingly, at most I might drink a six pack of low alcohol cider in a week, more likely two weeks or more. Studies have shown that PCBs attack the liver and can cause liver cancer, including fatty liver deposits. I would like to have further tests done to determine if I have PCB poisoning. Otherwise I have been told that they can determine it at the autopsy.

  4. Elvira M. Logan December 27, 2022 at 14:55

    I am thankful that the VA can finally start with these important trials. They were long overdue. My husband, MSgt l. P. Logan, died in April of 2022 of liver cancer. By having a better understanding and a wider picture of the disease, more patients will be helped.

  5. M C Hudson December 26, 2022 at 17:52

    When is test available

  6. Richard Cobb December 24, 2022 at 19:26

    I have been diagnosed with stage 3 and 4 cirrhosis of the liver, so I need more info, I was also exposed to agent orange in Vietnam.
    I have an appointment at Liver institute in Newport News, Va.

  7. Richard Cobb December 24, 2022 at 19:24

    I have been diagnosed with stage 3 and 4 cirrhosis of the liver, so I need more info, I was also exposed to agent orange in Vietnam.

  8. Rodger D. Reddish December 23, 2022 at 12:26

    I have been Non-Alcohol all my life. Even so, I still wonder/ worry about my liver’s condition and etc since I was exposed to Agent Orange at Missile Sites and Missile used Radars while in the military.

    I am also an “Golden Age Competitor” for Recumbent Cycling.

  9. David SOMMER December 23, 2022 at 07:29

    I have stage 4 cirois of the liver and its because when I got to my permanent station at Ft. Bragg, NC. Drinking was encouraged the commanding general gave us a safety briefing when he ended he said “Don’t Let me catch any of you-uckers having more than three beers at lunch. Hell we beer machines in the barracks right next to the coke machines. There should be some compensation for this.

    • Scott December 29, 2022 at 00:06

      Seriously? Stop blaming other people for your bad decisions. No one forced you to drink…grow up!

  10. dgabel December 22, 2022 at 19:25

    I Have TERMINAL DISEASE and CANNOT get. HELP

  11. RICHARD F WICKER III December 22, 2022 at 18:55

    I believe I am an excellent candidate for this study – please tell me how I sign up

Comments are closed.

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