"Hepatocellular carcinoma surveillance: Current challenges in Latin America"

Hepatocellular carcinoma (HCC) is the most common primary liver cancer, predominantly linked with cirrhosis and chronic hepatitis B. In Latin America, disparities in healthcare access complicate HCC management. A recent expert meeting emphasized the importance of identifying at-risk populations for effective screening and surveillance, underlining the need for structured routine programs. Early detection of HCC improves outcomes and increases survival rates. Surveillance programs are essential, yet access to healthcare and treatment varies significantly across Latin America, making timely diagnosis and intervention challenging. Additionally, recent shifts in disease etiology, notably the rising prevalence of MASLD, further complicate HCC detection. Effective HCC surveillance relies on cost-efficient diagnostic tools. Ultrasound is the main screening method, though it has moderate sensitivity. In obese patients, achieving adequate visualization is particularly difficult. Combining ultrasound with alpha-fetoprotein (AFP) improves diagnostic accuracy. Biomarkers such as AFP are commonly used to diagnose and monitor HCC, but their predictive value remains limited. Integrating biomarkers with ultrasound or other novel markers may enhance detection; however, further research is necessary to validate these strategies. In conclusion, HCC surveillance remains a significant challenge in our region. A comprehensive, multifaceted approach is needed to improve early detection and clinical outcomes.