AbstractWe assessed the impact of the COVID-19 pandemic on hepatocellular carcinoma(HCC) surveillance among individuals with HCV diagnosed with cirrhosis in BritishColumbia (BC), Canada. We used data from the British Columbia Hepatitis TestersCohort (BC-HTC), including all individuals in the province tested for or diagnosedwith HCV from 1 January 1990 to 31 December 2015, to assess HCC surveillance.To analyse the impact of the pandemic on HCC surveillance, we used pre-policy(January 2018 to February 2020) and post-policy (March to December 2020) peri-ods. We conducted interrupted time series (ITS) analysis using a segmented linearregression model and included first-order autocorrelation terms. From January 2018to December 2020, 6546 HCC screenings were performed among 3429 individu-als with HCV and cirrhosis. The ITS model showed an immediate decrease in HCCscreenings in March and April 2020, with an overall level change of −71 screenings[95% confidence interval (CI): −105.9, −18.9]. We observed a significant decrease inHCC surveillance among study participants, regardless of HCV treatment status andage group, with the sharpest decrease among untreated HCV patients. A recovery ofHCC surveillance followed this decline, reflected in an increasing trend of 7.8 screen-ings (95% CI: 0.6, 13.5) per month during the post-policy period. There was no levelor trend change in the number of individuals diagnosed with HCC. We observed asharp decline in HCC surveillance among people living with HCV and cirrhosis in BCfollowing the COVID-19 pandemic control measures. HCC screening returned to pre-pandemic levels by mid-2020.
