HCC surveillance in cirrhosis (ultrasound + AFP)
People with cirrhosis or chronic hepatitis B get a liver ultrasound and a blood test every six months so cancer is caught while it is still curable.
Six-monthly ultrasound with or without AFP is recommended by AASLD, EASL and APASL; it detects HCC at an early stage in ~60-70% of adherent patients and is associated with better survival in cohort studies (no randomised trial outside China). Uptake is under 25% in many health systems. Abbreviated MRI, GALAD (gender, age, AFP-L3, AFP, DCP) and cfDNA methylation tests are being evaluated to improve sensitivity in obese and fatty-liver patients.
How it works
Risk-stratified imaging of a defined at-risk population (cirrhosis of any cause, HBV carriers) at an interval matched to tumour doubling time.
- Cheap, non-invasive
- Stage shift toward curative options
- Ultrasound sensitivity falls in obesity and steatosis
- Poor adherence and under-diagnosed cirrhosis (especially MASLD)
Latest papers
topQuery for this technology: (TITLE:"HCC surveillance in cirrhosis" OR ABSTRACT:"HCC surveillance in cirrhosis" OR TITLE:"ultrasound + AFP" OR ABSTRACT:"ultrasound + AFP") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about HCC surveillance in cirrhosis (ultrasound + AFP), not a curated reading list.