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The Need for Formalized Surveillance Programmes for Hepatocellular Carcinoma

World wide, 5-year survival rates for HCCs remain poor, because these tumours are frequently diagnosed a too late a stage for hepatic resection or liver transplantationto be a viable option. In the UK, surveillance programmes for HCC in patients with cirrhosis of all aetiologies need to be evaluated. Although controversial, a combination of regular 3–6-monthly hepatic ultrasound examinations and measurement of serum afetoprotein levels to detect HCCs at an earlier stage is a possible option. Recent studies from the USA have highlighted the cost effectiveness of such an approach,12 while another recent study of 417 cirrhotic patients from Italy has highlighted the increased survival in those who had a HCC detected during such a surveillance programme.13