Risk stratification and early detection biomarkers for precision HCC screening

Area of Science:

• Hepatology and Oncology
• Medical Diagnostics
• Public Health

Background:

• Hepatocellular carcinoma (HCC) mortality remains high due to late diagnosis, despite current screening recommendations for at-risk individuals.
• The shift in HCC etiologies from viral to metabolic liver diseases has expanded the at-risk population, challenging traditional screening's practicality and cost-effectiveness.
• Suboptimal performance of existing HCC screening tests necessitates novel modalities for improved early detection.

Approach:

• This review examines recent advancements in clinical, molecular, and imaging-based tools for HCC early detection.
• It discusses the conceptual framework and implementation strategies for translating these new tools into clinical practice.
• The focus is on developing individualized precision approaches to HCC screening.

Key Points:

• Current HCC screening strategies may not be cost-effective or practical given evolving disease etiologies and increased at-risk populations.
• There is a critical need for enhanced HCC screening tests with improved sensitivity and specificity.
• Integrating clinical, molecular, and imaging advancements offers a promising path toward personalized HCC detection.

Conclusions:

• Recent progress in diagnostic tools is expected to shift HCC screening from a "one-size-fits-all" model to individualized precision approaches.
• These advancements hold the potential to significantly improve early HCC detection rates.
• Ultimately, personalized screening strategies aim to improve the poor prognosis associated with hepatocellular carcinoma.