Hepatocellular carcinoma (HCC) is one of the fastest growing causes of cancer worldwide. Main interventions to improve Hepatocellular carcinoma treatment outcomes are early detection of HCC and treating the cause of the underlying liver disease.
Screening for hepatocellular carcinoma (HCC) in patients with chronic liver disease is crucial for early detection and improved outcomes. This is because there are no clinical features early in the disease course specific to hepatocellular carcinoma. Symptomatic disease is often locally or distally advanced with few therapeutic options and these have limited efficacy.
Because the principal risk factors for hepatocellular carcinoma are – cirrhosis and hepatitis B – screening should target patients with these conditions. The most common and most cost-effective screening methods are serial ultrasound and serum alpha-fetoprotein (AFP) testing. Screening is typically recommended every six months.
The National Comprehensive Cancer Network (NCCN) guidelines recommend screening with ultrasound, with or without alpha feto protein(AFP) testing, every 6 months in patients with cirrhosis due to any of the following conditions:
Hepatitis B or C
Alcohol
Genetic hemochromatosis
NAFLD
Stage 4 primary biliary cholangitis
Alpha-1-antitrypsin deficiency
Early detection through regular screening can lead to better outcomes, including the possibility of curative treatments.
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