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Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
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Related Experiment Video

Updated: Jul 20, 2025

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Is Screening for Hepatocellular Carcinoma Effective?

Rachel M Lee1, Maria C Russell2

  • 1Department of Surgery, Emory University, Atlanta, GA, USA.

Advances in Surgery
|August 3, 2023
PubMed
Summary

Screening for hepatocellular carcinoma (HCC) in cirrhosis patients shows association with earlier diagnosis and improved survival, despite lack of randomized trials. Further research is needed on barriers and optimal screening methods.

Keywords:
CirrhosisHepatocellular carcinomaScreeningSurveillance

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Area of Science:

  • Hepatology
  • Oncology
  • Medical Screening

Background:

  • Hepatocellular carcinoma (HCC) is a major cause of cancer death, primarily affecting patients with cirrhosis.
  • Current guidelines recommend semimonthly screening for HCC using ultrasound and alpha fetoprotein (AFP) in high-risk individuals.
  • The effectiveness of HCC screening in improving survival in cirrhosis patients remains controversial due to a lack of randomized controlled trials.

Purpose of the Study:

  • To evaluate the association of hepatocellular carcinoma (HCC) screening with diagnostic stage, treatment receipt, and survival in patients with cirrhosis.
  • To identify areas for further research to optimize HCC screening and treatment outcomes.

Main Methods:

  • Review of retrospective and cohort studies, and pooled analyses examining HCC screening effectiveness.
  • Analysis of associations between screening and stage at diagnosis, curative treatment, and overall survival.

Main Results:

  • Studies indicate that HCC screening is associated with earlier stage at diagnosis.
  • Screening is linked to increased receipt of curative-intent treatment for HCC.
  • Evidence suggests an association between screening and improved overall survival in patients with cirrhosis.

Conclusions:

  • Despite limitations like lead-time and length-time biases, existing studies provide a compelling argument for HCC screening in cirrhosis patients.
  • Further research is essential to address barriers to screening and treatment, and to determine optimal screening modalities amidst changing cirrhosis etiologies.