"Hepatocellular carcinoma surveillance: Current challenges in Latin America"

Area of Science:

• Hepatology
• Oncology
• Public Health

Background:

• Hepatocellular carcinoma (HCC) is the most common primary liver cancer, often associated with cirrhosis and chronic hepatitis B.
• Latin America experiences significant healthcare access disparities impacting HCC management and patient outcomes.
• Rising prevalence of Metabolic dysfunction-associated steatotic liver disease (MASLD) is altering HCC etiology.

Purpose of the Study:

• To highlight the challenges and importance of effective screening and surveillance programs for Hepatocellular carcinoma (HCC) in Latin America.
• To emphasize the need for structured, routine programs for early HCC detection to improve survival rates.
• To discuss the complexities of HCC detection due to evolving disease etiologies and diagnostic tool limitations.

Main Methods:

• Review of expert meeting discussions on HCC surveillance strategies in Latin America.
• Analysis of current screening methods, including ultrasound and alpha-fetoprotein (AFP) biomarkers.
• Consideration of diagnostic challenges, particularly in obese patients and with limited biomarker predictive value.

Main Results:

• Early detection of HCC significantly improves patient outcomes and survival rates.
• Ultrasound combined with AFP offers improved diagnostic accuracy over ultrasound alone.
• Current surveillance methods face limitations in sensitivity and accessibility across the region.

Conclusions:

• HCC surveillance in Latin America is complex, requiring a multifaceted approach.
• Improving access to healthcare and cost-efficient diagnostic tools is essential for effective HCC management.
• Further research is needed to validate integrated biomarker and imaging strategies for enhanced HCC detection.