Screening for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) currently has the fifth highest incidence rate among tumors worldwide, a rate expected to continue to increase over the next several decades. The majority of patients with HCC have cirrhosis of the liver, with chronic hepatitis B and C as the major agents of etiology. Despite advances in technology, the prognosis of patients with HCC has shown little improvement over time, most likely because most patients are diagnosed at advanced stages. HCC meets the criteria established by the World Health Organization for performing surveillance in those at risk for developing this tumor (ie, patients with cirrhosis of the liver). The objective of surveillance is to use a relatively simple and inexpensive examination in a large number of individuals to determine whether or not they are likely to develop cancer, with the overall goal of reducing morbidity and mortality from the cancer. In this article, we evaluate the criteria for performing surveillance for HCC and review the data on the efficacy of current surveillance programs.