The potential of multi- and single-cancer blood-based early detection tests in liver cancer screening

Liver cancer is one of the most common causes of cancer deaths worldwide. Although fatal when diagnosed at an advanced stage, liver cancer has a favorable prognosis when identified at an earlier stage. Guidelines for liver cancer screening do exist, currently recommending the use of ultrasound with or without hematologic markers for early detection of liver cancer. However, studies have revealed shortcomings in the current state of liver cancer screenings such as underutilization stemming from lack of primary care education and logistical barriers for patients, suboptimal sensitivity of current screening methods, and lack of screening for lower risk individuals. A multitude of liquid biopsy tests that use circulating genomic analytes for early detection of cancers are currently under development and have the potential clinical implications in the early detection of liver cancer. In this overview, we highlight limitations of current liver cancer screenings and the ongoing development of multicancer early detection tests as well as cancer specific blood tests for liver cancer. As these multi-analyte blood tests hold promise in filling the gaps of current shortcomings of liver cancer screenings, it is imperative for primary care physicians, oncologists, and hepatologists involved in the screening process to be aware of ongoing studies and the further research necessary to ascertain several parameters such as the cost-benefit ratio, mortality reduction, and sensitivities of the blood tests.