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Risk-stratified surveillance for hepatocellular carcinoma.

Thomas Hunold1, Neehar D Parikh

  • 1Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan, USA.

Hepatology Communications
|April 1, 2026
PubMed
Summary
This summary is machine-generated.

Risk-stratified surveillance for hepatocellular carcinoma (HCC) offers a personalized approach over current guidelines. Tailoring screening intensity to individual risk may improve outcomes for patients at risk of HCC.

Keywords:
cirrhosishepatitis Bhepatocellular carcinomaimplementationscreening

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Area of Science:

  • Hepatology
  • Oncology
  • Medical Screening

Background:

  • Hepatocellular carcinoma (HCC) is a major global cause of cancer mortality.
  • Current surveillance methods (ultrasound, alpha-fetoprotein) have limitations like low sensitivity and high false positives.
  • Individual HCC risk varies significantly, necessitating a more tailored approach.

Purpose of the Study:

  • To critically evaluate existing risk stratification models for HCC surveillance.
  • To identify challenges in implementing risk-stratified surveillance in clinical practice.
  • To assess the potential of individualized risk assessment in improving HCC outcomes.

Main Methods:

  • Systematic review and critical evaluation of HCC risk stratification models.
  • Categorization of models into clinical, biomarker-based, and imaging/elastography-based approaches.
  • Analysis of model performance, validation, and representation of diverse patient populations.

Main Results:

  • Several HCC risk stratification models show promise but often lack external validation.
  • Existing models may underrepresent patients with metabolic or alcohol-associated liver disease.
  • Models inadequately address competing risks like non-liver-related mortality.

Conclusions:

  • Risk-stratified surveillance for HCC presents a promising alternative to current uniform guidelines.
  • Further prospective validation and implementation studies are crucial for widespread adoption.
  • Personalized surveillance strategies hold potential to enhance outcomes for at-risk individuals.