Materiały źródłowe

• #1 Hepatocellular Carcinoma (HCC): Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/197319-overview

  In the US, the median age at diagnosis is 66 years. Most cases occur in men: Incidence rates per 100,000 persons are 14.1 in men and 5.2 in women. […] By racial and ethnic group, rates are highest in American Indian/Alaska Natives, followed by Hispanics, Asians/Pacific Islanders, then Blacks, and whites. […] Worldwide, liver cancer was the sixth most common cancer and the third most common cause of cancer deaths in 2020, with an estimated 905,677 new cases and 830,180 deaths. […] The incidence was highest in East Asia, at 17.9 per 100,000 population (26.9 in males and 8.9 in females), followed by Micronesia, northern Africa, Southeast Asia, and Melanesia. […] The incidence rate was 6.9 per 100,00 in northern America and 5.6 per 100,000 in western Europe. Overall, the incidence rate of liver cancer is approximately three times higher in males than in females.

• #2 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Hepatocellular carcinoma (HCC) burden is highest in East Asia and Africa, although its incidence and mortality are rapidly rising in the United States and Europe. […] Surveillance using ultrasound with or without alpha fetoprotein every 6 months has been associated with improved early detection and improved overall survival; however, limitations in implementation lead to a high proportion of HCC being detected at late stages in clinical practice. […] The worldwide incidence of HCC is heterogeneous because of the variable prevalence of underlying risk factors. […] Age-standardized mortality rates (ASMR) from HCC in 2018 are also highest in Eastern Asia (16.0) and Northern Africa (13.9) followed by South Eastern Asia (13.2). […] The large majority of HCC cases occur in the setting of chronic liver disease, with cirrhosis being the primary risk factor for HCC independent of liver disease etiology.

• #3 Liver and Intrahepatic Bile Duct Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/livibd.html

  Estimated New Cases in 2025 42,240. […] % of All New Cancer Cases 2.1%. […] Estimated Deaths in 2025 30,090. […] % of All Cancer Deaths 4.9%. […] The rate of new cases of liver and intrahepatic bile duct cancer was 9.4 per 100,000 men and women per year. […] The death rate was 6.6 per 100,000 men and women per year. […] Approximately 1.1 percent of men and women will be diagnosed with liver and intrahepatic bile duct cancer at some point during their lifetime, based on 20182021 data, excluding 2020 due to COVID. […] In 2022, there were an estimated 113,557 people living with liver and intrahepatic bile duct cancer in the United States. […] Liver cancer is more common in men than women and among non-Hispanic American Indian/Alaska Native and Hispanic populations. […] The rate of new cases of liver and intrahepatic bile duct cancer was 9.4 per 100,000 men and women per year based on 20182022 cases, age-adjusted.

• #4

  https://www.roche.com/stories/liver-cancer-importance-of-digital-diagnostics-and-surveillance

  Liver cancer is now the third leading cause of cancer death and the number of deaths due to liver cancer is estimated to rise in the future. In fact, more than 900,000 people are diagnosed with the most common form of liver cancer, hepatocellular cancer (HCC), annually. Unfortunately, the majority of diagnoses occur in the late stages of disease, resulting in an overall survival rate of less than 16% after five years. […] Approximately 20 to 43% of liver cancer patients are diagnosed at an early stage. Of HCC patients, which are diagnosed with late-stage disease, less than 16% survive a period of 5 years. Of the patients diagnosed at an early stage, more than 70% may be alive after five years. Therefore, diagnosing HCC as early as possible is essential to improving patient outcomes. The goal of HCC surveillance is to reduce HCC-related mortality by promoting very-early tumor detection and facilitating curative treatments. […] current data suggest HCC surveillance is of high value and should be promoted in patients with cirrhosis, particularly given the low proportion of surveillance-detected HCC cases across studies.

• #5 IDDF2024-ABS-0455 Global epidemiology of liver cancer subtypes: insights from a comprehensive analysis | Gut

  https://gut.bmj.com/content/73/Suppl_2/A275.1

  Liver cancer is a significant global health burden, with distinct subtypes that exhibit variations in etiology, clinical presentation, and treatment approaches. This study aims to provide a comprehensive analysis of the current global incidence of liver cancer, stratified by its major histological subtypes. […] In 2022, the global incidence of liver cancer was estimated to be 8.6 per 100,000 individuals, accounting for a cumulative total of 865,835 cases. Our comprehensive analysis revealed that hepatocellular carcinoma (HCC) accounted for 74.5% of liver cancer cases, while intrahepatic cholangiocarcinoma (iCCA) accounted for 20.8%. Notably, a significantly higher proportion of HCC cases was observed in males (79.5%) compared to females (63.2%), as well as in the younger demographic (78.7%) compared to the older population (74.7%). In terms of geographical regions, sub-Saharan Africa and Eastern Asia exhibited the highest proportions of HCC, surpassing 80% of total liver cancer cases. Conversely, the greatest prevalence of iCCA was reported in Northern Africa (45.6%), Europe (37.2%), and Latin America (35.5%).

• #6 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Hepatocellular carcinoma (HCC) burden is highest in East Asia and Africa, although its incidence and mortality are rapidly rising in the United States and Europe. […] Surveillance using ultrasound with or without alpha fetoprotein every 6 months has been associated with improved early detection and improved overall survival; however, limitations in implementation lead to a high proportion of HCC being detected at late stages in clinical practice. […] The worldwide incidence of HCC is heterogeneous because of the variable prevalence of underlying risk factors. […] Age-standardized mortality rates (ASMR) from HCC in 2018 are also highest in Eastern Asia (16.0) and Northern Africa (13.9) followed by South Eastern Asia (13.2). […] The large majority of HCC cases occur in the setting of chronic liver disease, with cirrhosis being the primary risk factor for HCC independent of liver disease etiology.

• #7 Epidemiology of hepatocellular carcinoma in sub-Saharan Africa | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-epidemiology-hepatocellular-carcinoma-in-sub-saharan-S1665268119313547

  Published incidences of hepatocellular carcinoma in the Black population of sub-Saharan Africa underestimate the true incidence of the tumor because of the many instances in which hepatocellular carcinoma is either not definitively diagnosed or is not recorded in a cancer registry. […] Despite this, it is manifestly evident that the tumor occurs commonly and is a major cause of cancer deaths in Black African peoples living in the sub-continent, particularly in those living in rural areas. 46,000 new cases of hepatocellular carcinoma have been recorded to be diagnosed in sub-Saharan Africa each year, and age-standardized incidences of the tumor as high as 41.2/100,000 persons/year have been documented. […] The highest incidence of hepatocellular carcinoma has been recorded in Mozambique.

• #8 Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide

  https://www.e-jlc.org/journal/view.php?number=557

  Approximately 80% of hepatocellular carcinoma (HCC) cases arise in sub-Saharan Africa and Eastern Asia, following a similarly high prevalence of chronic hepatitis B virus (HBV) carriers in these regions. […] The etiology and epidemiology of HCC have recently changed worldwide. […] Although HBV infection is the main contributor to HCC development, a slow but continuous decline in HBV infection rates has been reported since 1990. […] The overall global burden of HCC has increased over time. […] Significant differences exist worldwide in the incidence and mortality of HCC, primarily due to differences in the timing and exposure to environmental and infectious risk factors, accessibility to healthcare resources, and the capability to detect early-stage HCC and provide potentially curative treatment.

• #9 Liver cancer in China: the analysis of mortality and burden of disease trends from 2008 to 2021 | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12334-2

  The mortality and disease burdens of liver cancer in China decreased yearly and were higher in males and in people living in rural areas, with significant differences among those living in eastern, central, and western China. […] In 2021, the ASMR of liver cancer in China was 17.95/100,000, which is higher than the global standardized rate of 8.7/100,000. […] From 2008 to 2021, the ASMRs of liver cancer in China and in male, female, urban, rural, eastern, central and western residents decreased at average annual rates of 3.40%, 3.30%, 3.50%, 3.00%, 3.20%, 3.70%, 2.90%, 2.40%, respectively (P0.001). […] From 2008 to 2021, the PYLLR of liver cancer in China and in male, female, urban, rural, eastern, central, and western residents decreased at an average annual rate of 2.40%, 2.20%, 2.90%, 3.30%, 2.50%, 3.40%, 2.30%, 2.10%, respectively.

• #10 Burden of liver cancer: From epidemiology to prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9829497/

  In this review, we offer a concise overview of liver cancer epidemiology in China and worldwide from the official databases of GLOBOCAN 2020 and the National Cancer Registry in China. […] Overall, liver cancer was the sixth most commonly diagnosed cancer and the third leading cause of cancer-related death worldwide in 2020. […] Although China contributed to nearly half of cases across the world alone, the incidence and mortality rates of liver cancer presented a declining trend owing to the persistent efforts from the governments at all levels. […] The current liver cancer burden in China still faces an arduous challenge due to the relatively large population base as well as the substantially low survival rate (12.1%). […] The promotion of surveillance is also an important method to prolong the survival of liver cancer.

• #11 Liver cancer in the world: epidemiology, incidence, mortality and risk factors – WCRJ

  https://www.wcrj.net/article/1082

  Liver cancer is the sixth common cancer and the second leading cause of death from cancer around the world. It is significantly more observable among male with its highest incidence in the age group of 45 to 60 years. […] The standard incidence of liver cancer was 10.1 per 100,000 people (15.3 in males and 5.3 in females). The highest mortality rates occurred observed in the East Asian countries. The standardized mortality rate for liver cancer was 9.5 per 100,000 people (14.3 in males and 5.1 in females). […] The most important risk factors for liver cancer included the chronic infections with HBV and HCV, Aflatoxin, alcohol consumption and cigarette smoking. […] Liver cancer has a higher incidence rate in East Asian countries. Majority of the cases are detected mostly at the advanced level of disease. Then, an early diagnosis could be effective in reducing mortality rate of this cancer. Also, comparing HCV(hepatitis C virus) and HIV (human immunodeficiency virus) may lead to reducing risk factors of liver cancer.

• #12 Hepatocellular Carcinoma (HCC): Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/197319-overview

  In the US, the median age at diagnosis is 66 years. Most cases occur in men: Incidence rates per 100,000 persons are 14.1 in men and 5.2 in women. […] By racial and ethnic group, rates are highest in American Indian/Alaska Natives, followed by Hispanics, Asians/Pacific Islanders, then Blacks, and whites. […] Worldwide, liver cancer was the sixth most common cancer and the third most common cause of cancer deaths in 2020, with an estimated 905,677 new cases and 830,180 deaths. […] The incidence was highest in East Asia, at 17.9 per 100,000 population (26.9 in males and 8.9 in females), followed by Micronesia, northern Africa, Southeast Asia, and Melanesia. […] The incidence rate was 6.9 per 100,00 in northern America and 5.6 per 100,000 in western Europe. Overall, the incidence rate of liver cancer is approximately three times higher in males than in females.

• #13 Liver and Intrahepatic Bile Duct Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/livibd.html

  Estimated New Cases in 2025 42,240. […] % of All New Cancer Cases 2.1%. […] Estimated Deaths in 2025 30,090. […] % of All Cancer Deaths 4.9%. […] The rate of new cases of liver and intrahepatic bile duct cancer was 9.4 per 100,000 men and women per year. […] The death rate was 6.6 per 100,000 men and women per year. […] Approximately 1.1 percent of men and women will be diagnosed with liver and intrahepatic bile duct cancer at some point during their lifetime, based on 20182021 data, excluding 2020 due to COVID. […] In 2022, there were an estimated 113,557 people living with liver and intrahepatic bile duct cancer in the United States. […] Liver cancer is more common in men than women and among non-Hispanic American Indian/Alaska Native and Hispanic populations. […] The rate of new cases of liver and intrahepatic bile duct cancer was 9.4 per 100,000 men and women per year based on 20182022 cases, age-adjusted.

• #14 Core Concepts – Surveillance for Hepatocellular Carcinoma – Evaluation, Staging, and Monitoring of Chronic Hepatitis C – Hepatitis C Online

  https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/surveillance-hepatocellular-carcinoma/core-concept/all

  In 2020, hepatocellular carcinoma (HCC) was the seventh most common malignancy worldwide, with approximately 900,00 cases, and the second leading cause of cancer-related death. The rates of liver cancer are highest in Asia and in Northern Africa. Among all cases of liver cancer globally, the rates are much higher in males (14.1 per 100,000 people) than in females (5.2 per 100,000 people). […] In the United States, the National Cancer Institute (NCI) data for liver cancer combines liver and intrahepatic bile duct carcinoma. The annual reported rate of liver cancer in the United States has changed significantly in the past 30 years. In 1992, the rate of new cases of liver and intrahepatic bile duct carcinoma was 4.46 per 100,000 persons, but this increased steadily to a peak of 9.38 cases per 100,000 persons in 2015, followed by a decrease in recent years. In 2023, there were an estimated 41,210 new cases of liver and intrahepatic bile duct carcinoma reported in the United States, accounting for 2.1% of all new cancer cases. The significant increase in HCC incidence in the United States over the past 30 years has been largely attributable to HCV-related HCC. Rates of liver cancer in the United States show major differences based on sex, age, and race/ethnicity. Data from 2000 to 2020 showed rates of liver and intrahepatic bile duct carcinoma in the United States are consistently higher in males than females. Most of the cases of liver and intrahepatic bile duct carcinoma have occurred in persons 55 to 74 years of age, with a median age of 66 years for persons newly diagnosed with liver cancer. There are significant differences in new liver cancer diagnoses based on race/ethnicity, with the highest rates among American Indian/Alaska Natives and Hispanic people. From 2016-2020, liver and intrahepatic bile duct cancer was the sixth leading cause of cancer death in the United States, and the median age of those who died was 68 years.

• #15 Global epidemiology of early-onset liver cancer attributable to specific aetiologies and risk factors from 2010 to 2019 — JOGH

  https://jogh.org/2023/jogh-13-04167/

  Global epidemiology of early-onset liver cancer attributable to specific aetiologies and risk factors from 2010 to 2019 […] Liver cancer is the third most lethal malignancy globally, with 830,000 deaths in 2020 and with an age distribution shifting toward younger groups. Early-onset liver cancer, often defined as liver cancer diagnosed in individuals <50 years of age, has become increasingly common, accounting for 15%-26% of total liver cancers worldwide. For instance, a study conducted in the USA found that the incidence of liver cancer increased faster in people aged 45-49 years than in 75-79 years (three- vs 2-fold). Moreover, early-onset liver cancer may have a lower prevalence of underlying cirrhosis and an inferior prognosis than late-onset liver cancer. This suggests that determining the burden of early-onset liver cancer is crucial to understanding the global epidemiology of liver cancer and establishing related prevention efforts.

• #16 Key Statistics About Liver Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/liver-cancer/about/what-is-key-statistics.html

  About 42,240 new cases (28,220 in men and 14,020 in women) will be diagnosed. […] About 30,090 people (19,250 men and 10,840 women) will die of these cancers. […] Liver cancer incidence rates have more than tripled since 1980, while the death rates have more than doubled during this time. […] Liver cancer is much more common in countries in sub-Saharan Africa and Southeast Asia than in the US. […] More than 800,000 people are diagnosed with this cancer each year throughout the world. […] Liver cancer is also a leading cause of cancer deaths worldwide, accounting for more than 700,000 deaths each year.

• #17 Time-trends in liver cancer incidence and mortality rates in the U.S. from 1975 to 2017: a study based on the Surveillance, Epidemiology, and End Results database – Yao – Journal of Gastrointestinal Oncology

  https://jgo.amegroups.org/article/view/72622/html

  The overall incidence increased significantly from 2.641/100,000 person-years in 1975 to 8.657/100,000 person-years in 2017 [average annual percent change (AAPC) =3.42, 95% confidence interval (CI): 3.283.62, P0.001]. […] The overall mortality rate increased from 2.808/100,000 person-years in 1975 to 6.648/100,000 person-years in 2017 (AAPC =2.41, 95% CI: 2.292.51, P0.001). […] The incidence and mortality rates of HCC and ICC increased from 1975 to 2017, especially in males, non-Hispanic Blacks and older individuals. […] The incidence of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) increased from 2.641/100,000 person-years in 1975 to 8.657/100,000 person-years in 2017. […] The mortality rate increased from 2.808/100,000 person-years in 1975 to 6.648/100,000 person-years. […] The incidence and mortality rates of males, non-Hispanic Blacks, and older individuals exhibited a more rapid increase. […] In states with high mortality, establishing a screening program may assist in early diagnosis and intervention before the clinical manifestation becomes fatal.

• #18 Time-trends in liver cancer incidence and mortality rates in the U.S. from 1975 to 2017: a study based on the Surveillance, Epidemiology, and End Results database – Yao – Journal of Gastrointestinal Oncology

  https://jgo.amegroups.org/article/view/72622/html

  The overall incidence increased significantly from 2.641/100,000 person-years in 1975 to 8.657/100,000 person-years in 2017 [average annual percent change (AAPC) =3.42, 95% confidence interval (CI): 3.283.62, P0.001]. […] The overall mortality rate increased from 2.808/100,000 person-years in 1975 to 6.648/100,000 person-years in 2017 (AAPC =2.41, 95% CI: 2.292.51, P0.001). […] The incidence and mortality rates of HCC and ICC increased from 1975 to 2017, especially in males, non-Hispanic Blacks and older individuals. […] The incidence of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) increased from 2.641/100,000 person-years in 1975 to 8.657/100,000 person-years in 2017. […] The mortality rate increased from 2.808/100,000 person-years in 1975 to 6.648/100,000 person-years. […] The incidence and mortality rates of males, non-Hispanic Blacks, and older individuals exhibited a more rapid increase. […] In states with high mortality, establishing a screening program may assist in early diagnosis and intervention before the clinical manifestation becomes fatal.

• #19 Barriers to surveillance for hepatocellular cancer among patients with chronic liver disease -providers’ perspectives

  https://www.oaepublish.com/articles/2394-5079.2023.75

  Aims: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. While patients who are known to be at high risk for HCC should be under surveillance, only 20% of eligible patients in the United States are surveilled. The aim of this study was to identify providers perspectives about patient-, provider- and system-level barriers to surveillance for HCC among high-risk patients and to examine provider knowledge and attitudes related to HCC surveillance. We also explored interventions providers suggested as ways to improve HCC surveillance. […] Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related death worldwide – and the fastest-growing cause of cancer-related deaths in the United States (US). The prognosis is dismal – with only a 15% 5-year survival rate; however, patients diagnosed early are candidates for potentially curative therapies.

• #20 Liver cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/liver-cancer

  There are around 6,600 new liver cancer cases in the UK every year, that’s 18 every day (2017-2019). […] Liver cancer is the 17th most common cancer in the UK, accounting for 2% of all new cancer cases (2017-2019). […] Since the early 1990s, liver cancer incidence rates have increased by more than two-and-a-half times (177%) in the UK. […] Over the last decade, liver cancer incidence rates have increased by more than two-fifths (42%) in the UK. […] Liver cancer incidence rates are projected to rise by 6% in the UK between 2023-2025 and 2038-2040. […] Liver cancer mortality rates are projected to rise by 10% in the UK between 2023-2025 and 2038-2040. […] Almost 1 in 10 (8.0%) people diagnosed with liver cancer in England survive their disease for ten years or more, it is predicted (2013-2017). […] Liver cancer five-year survival in England is higher in males than females (2016-2020). […] 49% of liver cancer cases in the UK are preventable.

• #21 Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide

  https://www.e-jlc.org/journal/view.php?number=557

  The incidence in Japan has dropped drastically with a significant reduction in the population infected by hepatitis C virus (HCV). […] In Korea, the age-standardized incidence of liver cancer significantly decreased from 28.9 in 1999 to 19.7 in 2014 and 16.1 in 2019. […] The incidence of HBV-related HCC decreased, while the incidence of alcohol- and NAFLD-associated HCC increased from 8.7% and 9.9% to 12.3% and 13.6%, respectively. […] NAFLD has now become the fastest-growing cause of HCC among liver transplant recipients and candidates on the waiting list in the United States, with similar trends observed in Europe, South Korea, and Southeast Asia over the past 2 decades. […] The etiology and epidemiology of HCC are rapidly changing worldwide. This trend indicates a transition from viral to non-viral causes and an increasing incidence of alcohol- and NAFLD-related HCC.

• #22 Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide

  https://www.e-jlc.org/journal/view.php?number=557

  The incidence in Japan has dropped drastically with a significant reduction in the population infected by hepatitis C virus (HCV). […] In Korea, the age-standardized incidence of liver cancer significantly decreased from 28.9 in 1999 to 19.7 in 2014 and 16.1 in 2019. […] The incidence of HBV-related HCC decreased, while the incidence of alcohol- and NAFLD-associated HCC increased from 8.7% and 9.9% to 12.3% and 13.6%, respectively. […] NAFLD has now become the fastest-growing cause of HCC among liver transplant recipients and candidates on the waiting list in the United States, with similar trends observed in Europe, South Korea, and Southeast Asia over the past 2 decades. […] The etiology and epidemiology of HCC are rapidly changing worldwide. This trend indicates a transition from viral to non-viral causes and an increasing incidence of alcohol- and NAFLD-related HCC.

• #23 Liver cancer in China: the analysis of mortality and burden of disease trends from 2008 to 2021 | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12334-2

  Liver cancer is one of the most common cancers in China. To understand the basic death situation and disease burden change trend, we analyze the death information of liver cancer among Chinese residents from 2008 to 2021. […] The ASMR of liver cancer in Chinese residents decreased from 27.58/100,000 in 2008 to 17.95/100,000 in 2021 at an average annual rate of 3.40% (t=-5.10, P0.001). […] The mortality rate was higher in males than in females (all P0.001) and higher in rural areas than in urban areas (all P0.001). […] The mortality rate of liver cancer varied significantly among eastern, central, and western China (all P0.001). […] The PYLLR of liver cancer in Chinese residents decreased from 2.89 in 2008 to 2.06 in 2021 at an average annual rate of 2.40% (t=-5.10, P0.001). […] The risk of China liver cancer mortality increased with age, decreased with birth cohort.

• #24 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Hepatocellular carcinoma (HCC) burden is highest in East Asia and Africa, although its incidence and mortality are rapidly rising in the United States and Europe. […] Surveillance using ultrasound with or without alpha fetoprotein every 6 months has been associated with improved early detection and improved overall survival; however, limitations in implementation lead to a high proportion of HCC being detected at late stages in clinical practice. […] The worldwide incidence of HCC is heterogeneous because of the variable prevalence of underlying risk factors. […] Age-standardized mortality rates (ASMR) from HCC in 2018 are also highest in Eastern Asia (16.0) and Northern Africa (13.9) followed by South Eastern Asia (13.2). […] The large majority of HCC cases occur in the setting of chronic liver disease, with cirrhosis being the primary risk factor for HCC independent of liver disease etiology.

• #25 Regular checks for liver cancer (surveillance) – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/diagnosis-and-care/regular-checks-for-liver-cancer/

  Up to 9 in 10 people who have hepatocellular carcinoma (HCC) liver cancer also have cirrhosis. […] Liver disease and liver cancer share a lot of the same causes. Hepatitis B and C viruses, drinking too much alcohol and carrying extra bodyweight have all been shown to cause liver cancer as well as causing liver damage and cirrhosis.

• #26 Liver cancer in the world: epidemiology, incidence, mortality and risk factors – WCRJ

  https://www.wcrj.net/article/1082

  Liver cancer is the sixth common cancer and the second leading cause of death from cancer around the world. It is significantly more observable among male with its highest incidence in the age group of 45 to 60 years. […] The standard incidence of liver cancer was 10.1 per 100,000 people (15.3 in males and 5.3 in females). The highest mortality rates occurred observed in the East Asian countries. The standardized mortality rate for liver cancer was 9.5 per 100,000 people (14.3 in males and 5.1 in females). […] The most important risk factors for liver cancer included the chronic infections with HBV and HCV, Aflatoxin, alcohol consumption and cigarette smoking. […] Liver cancer has a higher incidence rate in East Asian countries. Majority of the cases are detected mostly at the advanced level of disease. Then, an early diagnosis could be effective in reducing mortality rate of this cancer. Also, comparing HCV(hepatitis C virus) and HIV (human immunodeficiency virus) may lead to reducing risk factors of liver cancer.

• #27 Epidemiology of Liver Cancer: An Overview

  https://journal.waocp.org/article_24240.html

  The incidence of liver cancer varies widely throughout the world, with high rates in sub Saharan Africa, eastern and southeastern Asia, and Melanesia and a low incidence in Northern and Western Europe and the Americas. […] Hepatocellular cancer is a frequently occurring tumor in individuals in many developing countries, where several important risk factors have been demonstrated, including chronic infection with hepatitis B and C viruses and other environmental factors, such as exposure to aflatoxin, consumption of alcohol, and cigarette smoking. […] By contrast, cholangiocarcinoma is less common, accounting for only 7.7% of malignant tumors of the liver in the United States. However, in parts of Southeast Asia, cholangiocarcinoma occurs more frequently; it is responsible for more than 60% of liver tumors in northeastern Thailand.

• #28 Liver cancer in the world: epidemiology, incidence, mortality and risk factors – WCRJ

  https://www.wcrj.net/article/1082

  Liver cancer is the sixth common cancer and the second leading cause of death from cancer around the world. It is significantly more observable among male with its highest incidence in the age group of 45 to 60 years. […] The standard incidence of liver cancer was 10.1 per 100,000 people (15.3 in males and 5.3 in females). The highest mortality rates occurred observed in the East Asian countries. The standardized mortality rate for liver cancer was 9.5 per 100,000 people (14.3 in males and 5.1 in females). […] The most important risk factors for liver cancer included the chronic infections with HBV and HCV, Aflatoxin, alcohol consumption and cigarette smoking. […] Liver cancer has a higher incidence rate in East Asian countries. Majority of the cases are detected mostly at the advanced level of disease. Then, an early diagnosis could be effective in reducing mortality rate of this cancer. Also, comparing HCV(hepatitis C virus) and HIV (human immunodeficiency virus) may lead to reducing risk factors of liver cancer.

• #29 Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide

  https://www.e-jlc.org/journal/view.php?number=557

  The incidence in Japan has dropped drastically with a significant reduction in the population infected by hepatitis C virus (HCV). […] In Korea, the age-standardized incidence of liver cancer significantly decreased from 28.9 in 1999 to 19.7 in 2014 and 16.1 in 2019. […] The incidence of HBV-related HCC decreased, while the incidence of alcohol- and NAFLD-associated HCC increased from 8.7% and 9.9% to 12.3% and 13.6%, respectively. […] NAFLD has now become the fastest-growing cause of HCC among liver transplant recipients and candidates on the waiting list in the United States, with similar trends observed in Europe, South Korea, and Southeast Asia over the past 2 decades. […] The etiology and epidemiology of HCC are rapidly changing worldwide. This trend indicates a transition from viral to non-viral causes and an increasing incidence of alcohol- and NAFLD-related HCC.

• #30 Liver cancer in the world: epidemiology, incidence, mortality and risk factors – WCRJ

  https://www.wcrj.net/article/1082

  Liver cancer is the sixth common cancer and the second leading cause of death from cancer around the world. It is significantly more observable among male with its highest incidence in the age group of 45 to 60 years. […] The standard incidence of liver cancer was 10.1 per 100,000 people (15.3 in males and 5.3 in females). The highest mortality rates occurred observed in the East Asian countries. The standardized mortality rate for liver cancer was 9.5 per 100,000 people (14.3 in males and 5.1 in females). […] The most important risk factors for liver cancer included the chronic infections with HBV and HCV, Aflatoxin, alcohol consumption and cigarette smoking. […] Liver cancer has a higher incidence rate in East Asian countries. Majority of the cases are detected mostly at the advanced level of disease. Then, an early diagnosis could be effective in reducing mortality rate of this cancer. Also, comparing HCV(hepatitis C virus) and HIV (human immunodeficiency virus) may lead to reducing risk factors of liver cancer.

• #31 Liver cancer in the world: epidemiology, incidence, mortality and risk factors – WCRJ

  https://www.wcrj.net/article/1082

  Liver cancer is the sixth common cancer and the second leading cause of death from cancer around the world. It is significantly more observable among male with its highest incidence in the age group of 45 to 60 years. […] The standard incidence of liver cancer was 10.1 per 100,000 people (15.3 in males and 5.3 in females). The highest mortality rates occurred observed in the East Asian countries. The standardized mortality rate for liver cancer was 9.5 per 100,000 people (14.3 in males and 5.1 in females). […] The most important risk factors for liver cancer included the chronic infections with HBV and HCV, Aflatoxin, alcohol consumption and cigarette smoking. […] Liver cancer has a higher incidence rate in East Asian countries. Majority of the cases are detected mostly at the advanced level of disease. Then, an early diagnosis could be effective in reducing mortality rate of this cancer. Also, comparing HCV(hepatitis C virus) and HIV (human immunodeficiency virus) may lead to reducing risk factors of liver cancer.

• #32 Global epidemiology of early-onset liver cancer attributable to specific aetiologies and risk factors from 2010 to 2019 — JOGH

  https://jogh.org/2023/jogh-13-04167/

  Currently, the global epidemiological patterns of early-onset liver cancer attributable to aetiologies and nondeterministic aetiological risk factors (e.g. smoking, obesity, and diabetes) are regionally heterogeneous. For example, the duration of exposure to hepatitis B virus (HBV) infection plays a unique role in the differences in early-onset liver cancer prevalence between the East and West. The contribution of metabolic risk factors for early-onset liver cancer in different countries is still unclear, although a youthful obesity epidemic is spreading around the world. It is estimated that obesity has increased by 7.9% in children and adolescents and by 16.4% in adults from 2015 to 2019 in China. Growing parallel to the obesity epidemic among the youth, the longer duration of exposure to diabetes, non-alcoholic steatohepatitis (NASH), and non-alcoholic fatty liver disease (NAFLD) may also contribute to an increased burden of early-onset liver cancer.

• #33 JMIR Public Health and Surveillance – Development of a Prediction Model and Risk Score for Self-Assessment and High-Risk Population Identification in Liver Cancer Screening: Prospective Cohort Study

  https://publichealth.jmir.org/2024/1/e65286

  Background: Liver cancer continues to pose a significant burden in China. To enhance the efficiency of screening, it is crucial to implement population stratification for liver cancer surveillance. […] This study aimed to develop a simple prediction model and risk score for liver cancer screening in the general population, with the goal of improving early detection and survival. […] Key factors identified for the prediction model and risk score system included age (hazard ratio [HR] 1.06, 95% CI 1.04-1.08), sex (male: HR 3.41, 95% CI 2.44-4.78), education level (medium: HR 0.84, 95% CI 0.61-1.15; high: HR 0.37, 95% CI 0.17-0.78), cirrhosis (HR 11.93, 95% CI 7.46-19.09), diabetes (HR 1.59, 95% CI 1.08-2.34), and hepatitis B surface antigen (HBsAg) status (positive: HR 3.84, 95% CI 2.38-6.19; unknown: HR 1.04, 95% CI 0.73-1.49).

• #34 Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide

  https://www.e-jlc.org/journal/view.php?number=557

  The incidence in Japan has dropped drastically with a significant reduction in the population infected by hepatitis C virus (HCV). […] In Korea, the age-standardized incidence of liver cancer significantly decreased from 28.9 in 1999 to 19.7 in 2014 and 16.1 in 2019. […] The incidence of HBV-related HCC decreased, while the incidence of alcohol- and NAFLD-associated HCC increased from 8.7% and 9.9% to 12.3% and 13.6%, respectively. […] NAFLD has now become the fastest-growing cause of HCC among liver transplant recipients and candidates on the waiting list in the United States, with similar trends observed in Europe, South Korea, and Southeast Asia over the past 2 decades. […] The etiology and epidemiology of HCC are rapidly changing worldwide. This trend indicates a transition from viral to non-viral causes and an increasing incidence of alcohol- and NAFLD-related HCC.

• #35 Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide

  https://www.e-jlc.org/journal/view.php?number=557

  The incidence in Japan has dropped drastically with a significant reduction in the population infected by hepatitis C virus (HCV). […] In Korea, the age-standardized incidence of liver cancer significantly decreased from 28.9 in 1999 to 19.7 in 2014 and 16.1 in 2019. […] The incidence of HBV-related HCC decreased, while the incidence of alcohol- and NAFLD-associated HCC increased from 8.7% and 9.9% to 12.3% and 13.6%, respectively. […] NAFLD has now become the fastest-growing cause of HCC among liver transplant recipients and candidates on the waiting list in the United States, with similar trends observed in Europe, South Korea, and Southeast Asia over the past 2 decades. […] The etiology and epidemiology of HCC are rapidly changing worldwide. This trend indicates a transition from viral to non-viral causes and an increasing incidence of alcohol- and NAFLD-related HCC.

• #36 Changing etiology and epidemiology of hepatocellular carcinoma: Asia and worldwide

  https://www.e-jlc.org/journal/view.php?number=557

  The incidence in Japan has dropped drastically with a significant reduction in the population infected by hepatitis C virus (HCV). […] In Korea, the age-standardized incidence of liver cancer significantly decreased from 28.9 in 1999 to 19.7 in 2014 and 16.1 in 2019. […] The incidence of HBV-related HCC decreased, while the incidence of alcohol- and NAFLD-associated HCC increased from 8.7% and 9.9% to 12.3% and 13.6%, respectively. […] NAFLD has now become the fastest-growing cause of HCC among liver transplant recipients and candidates on the waiting list in the United States, with similar trends observed in Europe, South Korea, and Southeast Asia over the past 2 decades. […] The etiology and epidemiology of HCC are rapidly changing worldwide. This trend indicates a transition from viral to non-viral causes and an increasing incidence of alcohol- and NAFLD-related HCC.

• #37 Imaging Techniques for the Surveillance, Diagnosis, and Staging of Hepatocellular Carcinoma | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/liver-cancer/research-protocol

  Hepatocellular carcinoma (HCC) is the most common primary malignant neoplasm of the liver, usually developing in the setting of chronic liver disease and cirrhosis. Worldwide, it is the fifth most common cause of cancer and the third most common cause of cancer death. According to the National Cancer Institute, there were 156,940 deaths attributed to liver and intrahepatic bile duct cancer in the United States in 2011, with 221,130 new cases diagnosed. The National Cancer Institutes Surveillance, Epidemiology, and End Results Cancer Statistics Review found that the lifetime risk of developing liver and intrahepatic bile duct cancer is 1 in 132, with the age-adjusted incidence rate being 7.3 per 100,000 people per year. The highest incidence rates are found in Asian/Pacific Islanders (22.1 per 100,000 men and 8.4 per 100,000 women). The age-adjusted death rate is estimated at 5.2 per 100,000 people per year in the United States, with the highest sex-specific rates among Asian/Pacific Islander men (14.7 per 100,000) and American Indian/Alaskan Native women (6.6 per 100,000). The overall 5-year relative survival rate is 14.4 percent.

• #38 Burden of liver cancer: From epidemiology to prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9829497/

  In this review, we offer a concise overview of liver cancer epidemiology in China and worldwide from the official databases of GLOBOCAN 2020 and the National Cancer Registry in China. […] Overall, liver cancer was the sixth most commonly diagnosed cancer and the third leading cause of cancer-related death worldwide in 2020. […] Although China contributed to nearly half of cases across the world alone, the incidence and mortality rates of liver cancer presented a declining trend owing to the persistent efforts from the governments at all levels. […] The current liver cancer burden in China still faces an arduous challenge due to the relatively large population base as well as the substantially low survival rate (12.1%). […] The promotion of surveillance is also an important method to prolong the survival of liver cancer.

• #39 Surveillance for Hepatocellular Carcinoma Reduces Mortality: an Inverse Probability of Treatment Weighted Analysis | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-surveillance-for-hepatocellular-carcinoma-reduces-S1665268119304156

  Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the second leading cause of cancer death worldwide. Approximately 782,000 new cases are diagnosed with HCC annually and the global incidence has been increasing. It has been projected that by 2030, this number will increase by 53% or up to over 1.2 million cases. Outcomes of patients diagnosed with HCC vary substantially depending on the stage when the disease was detected. Patients diagnosed with an early stage, at which potential curative treatment is feasible, have a 5-year survival rate of 50-70% whereas those diagnosed with an advanced stage have a median survival of only 6 months. Therefore it is important to make the diagnosis at an early stage so the outcome of HCC can be significantly improved. […] A number of guidelines universally recommend screening and surveillance for HCC using ultrasonography and/or serum alpha-fetoprotein (AFP) among at-risk populations. Based on the American Association for the Study of Liver Disease (AASLD) and the European Association Study for the Study of the Liver (EASL) guidelines, active HCC surveillance by ultrasound every 6 months is recommended for individuals at-risk for HCC.

• #40

  https://www.roche.com/stories/liver-cancer-importance-of-digital-diagnostics-and-surveillance

  Liver cancer is now the third leading cause of cancer death and the number of deaths due to liver cancer is estimated to rise in the future. In fact, more than 900,000 people are diagnosed with the most common form of liver cancer, hepatocellular cancer (HCC), annually. Unfortunately, the majority of diagnoses occur in the late stages of disease, resulting in an overall survival rate of less than 16% after five years. […] Approximately 20 to 43% of liver cancer patients are diagnosed at an early stage. Of HCC patients, which are diagnosed with late-stage disease, less than 16% survive a period of 5 years. Of the patients diagnosed at an early stage, more than 70% may be alive after five years. Therefore, diagnosing HCC as early as possible is essential to improving patient outcomes. The goal of HCC surveillance is to reduce HCC-related mortality by promoting very-early tumor detection and facilitating curative treatments. […] current data suggest HCC surveillance is of high value and should be promoted in patients with cirrhosis, particularly given the low proportion of surveillance-detected HCC cases across studies.

• #41

  https://www.roche.com/stories/liver-cancer-importance-of-digital-diagnostics-and-surveillance

  Liver cancer is now the third leading cause of cancer death and the number of deaths due to liver cancer is estimated to rise in the future. In fact, more than 900,000 people are diagnosed with the most common form of liver cancer, hepatocellular cancer (HCC), annually. Unfortunately, the majority of diagnoses occur in the late stages of disease, resulting in an overall survival rate of less than 16% after five years. […] Approximately 20 to 43% of liver cancer patients are diagnosed at an early stage. Of HCC patients, which are diagnosed with late-stage disease, less than 16% survive a period of 5 years. Of the patients diagnosed at an early stage, more than 70% may be alive after five years. Therefore, diagnosing HCC as early as possible is essential to improving patient outcomes. The goal of HCC surveillance is to reduce HCC-related mortality by promoting very-early tumor detection and facilitating curative treatments. […] current data suggest HCC surveillance is of high value and should be promoted in patients with cirrhosis, particularly given the low proportion of surveillance-detected HCC cases across studies.

• #42 NHS England » Hepatocellular carcinoma surveillance: minimum standards

  https://www.england.nhs.uk/long-read/hepatocellular-carcinoma-surveillance-minimum-standards/

  Liver cancer is the fastest-rising cause of cancer related deaths in the UK. The most common form of primary liver cancer is hepatocellular carcinoma (HCC), which makes up 85% of all liver cancers. […] According to Cancer Research UK, around 6,200 people are diagnosed with liver cancer each year. Incidence of HCC has increased by 50% over the past decade and is expected to continue to rise. Existing evidence suggests that only around 20% of HCCs are currently diagnosed at an early stage (stages 1 or 2). […] National Institute for Health and Care Excellence (NICE) guidance recommends that people at high risk of HCC (those with hepatitis B and/or cirrhosis) receive 6-monthly liver surveillance (NG50, CG165, CG115). And while guidelines from NICE and the European Association for the Study of the Liver recommend HCC surveillance, fewer than half of patients who should receive surveillance actually do.

• #43 Improved surveillance may help reduce the HCC mortality rate

  https://www.oncoguardliver.com/news-and-research/hepatocellular-carcinoma-high-mortality-rate-improved-surveillance-may-help-reduce

  Hepatocellular carcinoma (HCC) is the most common form of liver cancer. Its also the fastest growing cause of cancer-related deaths in the United States. […] The American Cancer Society estimates that more than 40,000 new cases of HCC, occurring mostly in men, will be diagnosed in 2021. […] Hepatocellular carcinoma can be challenging to detect early because its signs and symptoms often do not appear until the more advanced stages of cancer. […] Despite these challenges, it is imperative to discover HCC as early as possible while curative treatment approaches are still available to the patient. […] Surveillance for HCC is underutilized. […] In the United States, only one third of the estimated 3 million patients who meet the criteria for surveillance receive it. […] We envision a future where people at high risk for HCC are not only promptly identified but encouraged and given support to help them adhere to a routine HCC surveillance program. […] Were also committed to developing a surveillance tool with high sensitivity to enable early-stage detection of HCC, thereby giving patients the chance to undergo potentially curative treatments.

• #44 Statistics about liver cancer – Liver Cancer UK

  https://livercanceruk.org/liver-cancer-information/statistics/

  Liver cancer is often diagnosed in A&E as an emergency. […] Data from England shows that 4 in 10 (40%) cases of liver cancer are diagnosed through an emergency route. This makes it the most common route. […] People diagnosed with late stage liver cancer are more likely to have been diagnosed through an emergency route than those with early stage disease. […] A 2023 analysis of liver cancer data on behalf of Liver Cancer UK shows that liver cancer rates across the UK are linked with deprivation. In all 4 nations, liver cancer rates are highest in people from the most deprived areas.

• #45 As Deadly Liver Cancer Rises, Collaborative, Targeted Prevention and Surveillance Necessary – Global Liver Institute

  https://globalliver.org/as-deadly-liver-cancer-rises-collaborative-targeted-prevention-and-surveillance-necessary/

  Global Liver Institute’s #OctoberIs4Livers Campaign Sheds Light on Unique Challenges and Solutions in Communities Facing Barriers […] Liver cancer continues to be one of the deadliest and increasingly common cancers worldwide. Because symptoms are not specific in early stages, most cases of liver cancer are not caught until the cancer has progressed. Hampered by delayed diagnosis, five-year survival of the disease hovers around 22% in the U.S. but around 58% in the most successful country, Japan. Up to 70% of cases of the disease are preventable – efforts to impede the development of liver cancer and to diagnose it early through robust screening are essential, especially for people with the greatest risk. […] Addressing disparities in liver cancer care remains a top priority for GLI. We’re thrilled to deepen our global partnerships and focus on some of the most vulnerable populations, including those in rural areas, Indigenous communities, immigrants and refugees, and U.S. veterans. […] A policy briefing and weekly roundtable series focusing on challenges and solutions that address disparities for communities at risk and actionable steps to support smart policies.

• #46 Liver cancer in Australia statistics | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/liver-cancer/liver-cancer-australia-statistics

  3,048 Estimated number of new cases of liver cancer diagnosed in 2023 […] 1.9% Estimated % of all new cancer cases diagnosed in 2023 […] 2,545 Estimated number of deaths from liver cancer in 2023 […] 5.0% Estimated % of all deaths from cancer in 2023 […] 23.0% Chance of surviving at least 5 years (2015–2019) […] In 2019, there were 2,416 new cases of liver cancer diagnosed in Australia (1,713 males and 703 females). In 2023, it is estimated that 3,048 new cases of liver cancer will be diagnosed in Australia (2,206 males and 842 females). In 2023, it is estimated that a person has a 1 in 103 (or 1.0%) risk of being diagnosed with liver cancer by the age of 85 (1 in 71 or 1.4% for males and 1 in 188 or 0.53% for females). […] In 2021, liver cancer was the seventh most common cause of cancer death in Australia. It is estimated that it will become the sixth most common cause of death from cancer in 2023.

• #47 Statistics about liver cancer – Liver Cancer UK

  https://livercanceruk.org/liver-cancer-information/statistics/

  This page has key statistics about liver cancer. This information is about liver cancer in the UK, so it isn’t a good guide to what may happen to an individual person. […] A major cause of liver cancer is underlying liver disease. You can read our statistics about liver disease on the British Liver Trust website. […] Liver cancer has one of the lowest survival rates of any cancer in the UK. Only 13% of people survive their liver cancer for 5 years or more. […] Only 3 in 10 liver cancer cases are diagnosed early at stages 1 or 2. […] Cancer is more likely to be cured when it is diagnosed at an early stage, before it has spread. Sadly, liver cancer is often diagnosed at a late stage. […] Worryingly a large proportion of liver cancer does not have a stage recorded. This makes it hard to understand how good we are at diagnosing liver cancer early and to measure any progress.

• #48

  https://ojph.org/index.php/OJPH/article/view/8514

  We explored associations between neighborhood deprivation and tumor characteristics, treatment, and 5-year survival among primary hepatocellular carcinoma (HCC) patients in Ohio diagnosed between 2008 and 2016. […] Neighborhood deprivation index was not associated with stage or tumor size. Individuals living in the most deprived neighborhoods were 16% less likely to receive guideline-concordant care as compared to individuals living in the least deprived neighborhoods (adjusted prevalence ratio [PR]: 0.84; 95% confidence interval [CI]: 0.74-0.94). […] Similarly, individuals living in the most deprived neighborhoods were 15% less likely to survive 5 years compared to individuals living in the least deprived neighborhoods (adjusted Hazard Ratio: 1.15; 95% CI: 1.01-1.29). […] Our results suggest a negative association between neighborhood deprivation on guideline-concordant care and survival among HCC patients. Interventions targeting disparities of HCC should focus not only on individual-level factors but address larger neighborhood level factors as well.

• #49 Liver cancer incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/liver-cancer/incidence

  For liver cancer, like most cancer types, incidence trends largely reflect changing prevalence of risk factors and improvements in diagnosis and data recording. […] Liver cancer incidence rates (European age-standardised (AS) rates) in England in females are 78% higher in the most deprived quintile compared with the least, and in males are 89% higher in the most deprived quintile compared with the least (2013-2017). […] It is estimated that there are around 1,200 more cases of liver cancer each year in England than there would be if every deprivation quintile had the same age-specific crude incidence rates as the least deprived quintile. […] An estimated 5,000 people who had been diagnosed with liver cancer between 1991 and 2010 were alive in the UK at the end of 2010.

• #50 Liver cancer in Australia statistics | Cancer Australia

  https://www.canceraustralia.gov.au/cancer-types/liver-cancer/liver-cancer-australia-statistics

  In 2021, there were 2,290 deaths from liver cancer in Australia (1,471 males and 819 females). In 2023, it is estimated that there will be 2,545 deaths (1,674 males and 871 females). In 2023, it is estimated that a person has a 1 in 122 (or 0.82%) risk of dying from liver cancer by the age of 85 (1 in 91 or 1.1% for males and 1 in 188 or 0.53% for females). […] In 2015–2019, individuals diagnosed with liver cancer had a 23% chance (23% for males and 22% for females) of surviving for five years compared to their counterparts in the general Australian population. Between 1990–1994 and 2015–2019, five-year relative survival for liver cancer increased from 7.6% to 23%. […] At the end of 2018, there were 1,531 people living who had been diagnosed with liver cancer that year, 4,332 people living who had been diagnosed with liver cancer in the previous 5 years (from 2014 to 2018) and 6,537 people living who had been diagnosed with liver cancer in the previous 37 years (from 1982 to 2018).

• #51 Temporal trends of incidence, mortality, and survival of liver cancer during 2011–2020 in Fujian Province, Southeast China | Archives of Public Health | Full Text

  https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-024-01462-7

  Liver cancer is a common malignant tumor of the digestive system. We aimed to estimate the trend in the burden of liver cancer in Fujian Province, China, during 20112020. There were 14,725 patients diagnosed with liver cancer and 12,698 patients died between 2011 and 2020. For males, there was a downward trend in incidence and mortality (AAPC: -3.86%, -3.44%). Similarly, the downward trend was also shown in females (AAPC: -3.96%, -2.79%). The overall age-standardized 5-year relative survival was 10.77% in 20112015 and 14.54% in 20162020. During the study period, the percentage improvement of survival was higher in males than in females (34.75% and 25.33%). The percentage improvement of survival in urban was higher than that in rural (38.64% and 28.75%). Except for the age group over 75, the survival of patients in other age groups all has improved. Liver cancer remains a serious public health problem in Fujian Province, China, which needs to be solved, especially in some high-risk groups such as the elderly, high-risk males, and rural populations. Early detection and treatment is the key to the prevention and treatment of liver cancer. The age-standardized incidence and mortality of liver cancer in Fujian Province in 2020 were 19.95/100,000 and 16.01/100,000, respectively, which were higher than the latest average levels in China. The burden of liver cancer began to rise with the increase of age. The peak of incidence and mortality in males were 75 years old and over 85 years old respectively, while the peak for females was in the age group of 80 years old. Regardless of gender or region, age-standardized incidence and mortality of liver cancer showed a downward trend from 2011 to 2020. Compared with 20112015, the age-standardized 5-year relative survival of liver cancer patients in 20162020 was higher. The elderly, high-risk males and rural populations are still high-risk groups for liver cancer. The government and health departments should take targeted measures to reduce the burden of liver cancer, including emphasizing regular screening for the elderly, promoting non-invasive screening technologies, and enhancing health education initiatives.

• #52 Liver Cancer Surveillance Is Life Saving [United States]

  https://healthcaresolutions-us.fujifilm.com/products/in-vitro-diagnostics/hcc-risk-biomarkers/liver-cancer-surveillance-life-saving/

  Liver cancer surveillance is the application of screening tests such as blood tests and ultrasonography at regular intervals, intended to identify liver cancer at an early stage in individuals who are at risk. […] Robust surveillance in high risk patients is critical to finding liver cancer in its early stage which is when more effective treatment options are available and can be applied with more success. […] Practice guidelines from the American Association for the Study of Liver Diseases (AASLD) and National Comprehensive Cancer Network (NCCN) recommend primary liver cancer surveillance by periodic screening (every 3-6 months) for patients at high-risk for liver cancer development. Collectively, evidence supports surveillance in high-risk groups. […] Elevated values in these blood tests (DCP or AFP-L3) have been shown to be associated with an increased risk of developing liver cancer.

• #53 Regular checks for liver cancer (surveillance) – Liver Cancer UK

  https://livercanceruk.org/liver-cancer-information/types-of-liver-cancer/hcc/diagnosing-hcc/surveillance/

  Finding liver cancer early can make a big difference. You are far more likely to be successfully treated and cured if treatment starts when the cancer is still small. […] There is no national screening programme for liver cancer. Most people who get HCC liver cancer have liver disease. So there are regular checks for people whose liver condition puts them at a higher risk of liver cancer. These checks will look at your liver and help to find any problems early. […] You might hear these checks called “surveillance.” Surveillance just means that health care professionals are keeping an eye on your liver for any signs of cancer. […] Liver cancer surveillance is regular checks on your liver. These look for the first signs of liver cancer. […] Regular checks for liver cancer are usually only available if your liver condition is serious and puts you at higher risk of getting liver cancer.

• #54 Hepatocellular Carcinoma: Surveillance, Diagnosis, Evaluation and Management

  https://www.mdpi.com/2072-6694/15/21/5118

  The implementation of surveillance programs for chronic liver disease, cirrhosis, and HCC allows for earlier tumor detection, curative treatment, and longer overall survival, as compared to when patients present symptomatically with the advanced disease. […] The goal of surveillance programs is to identify early-stage HCC in at-risk patients (cirrhosis from any etiology, HBV in the absence of cirrhosis, and HCV in the absence of cirrhosis), when curative-intent treatment is an option. The American Association for the Study of Liver Diseases (AASLD), Asian Pacific Association for the Study of the Liver (APASL), the National Comprehensive Cancer Network (NCCN), and the European Association for the Study of the Liver (EASL) all recommend surveillance every six months for these high-risk patients.

• #55 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Hepatocellular carcinoma (HCC) burden is highest in East Asia and Africa, although its incidence and mortality are rapidly rising in the United States and Europe. […] Surveillance using ultrasound with or without alpha fetoprotein every 6 months has been associated with improved early detection and improved overall survival; however, limitations in implementation lead to a high proportion of HCC being detected at late stages in clinical practice. […] The worldwide incidence of HCC is heterogeneous because of the variable prevalence of underlying risk factors. […] Age-standardized mortality rates (ASMR) from HCC in 2018 are also highest in Eastern Asia (16.0) and Northern Africa (13.9) followed by South Eastern Asia (13.2). […] The large majority of HCC cases occur in the setting of chronic liver disease, with cirrhosis being the primary risk factor for HCC independent of liver disease etiology.

• #56 NHS England » Hepatocellular carcinoma surveillance: minimum standards

  https://www.england.nhs.uk/long-read/hepatocellular-carcinoma-surveillance-minimum-standards/

  On average, patients in regular ultrasound surveillance have their cancers detected earlier and receive more curative intent treatment. […] Regular 6-monthly surveillance of adults with cirrhosis or advanced fibrosis and conditions including hepatitis B and hepatitis C (as set out in the eligibility criteria below) increases the chance of detecting HCC early so that patients can benefit from potentially curative treatment, and improved chances of survival. […] Significant challenges remain in identifying patients at risk of hepatocellular carcinoma and maintaining them in surveillance programmes, particularly those with a history of frequent drug or alcohol use, or who are experiencing homelessness. […] The NHS Cancer Programmes Early Diagnosis of Liver Cancer Programme is aiming to support liver services invite 80% of patients with cirrhosis or advanced fibrosis (and meet the eligibility criteria, above) to 6-monthly ultrasound surveillance and support 60% of those invited to attend.

• #57 The Impact of National Surveillance for Liver Cancer: Results from Real-World Setting in Korea

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl18522

  The survival probability of the surveillance group was statistically higher throughout the entire follow-up period (p0.0001, Renyi test) as compared with the no-surveillance group. […] The mortality risk of patients who underwent the surveillance program once 2 years prior to the diagnosis of LC was 22.0% lower (HR, 0.78; 95% CI, 0.76 to 0.80) as compared with the patients who did not participate in the program.

• #58 Surveillance for Hepatocellular Carcinoma Reduces Mortality: an Inverse Probability of Treatment Weighted Analysis | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-surveillance-for-hepatocellular-carcinoma-reduces-S1665268119304156

  We found that patients in the surveillance program had a significantly better survival than those who did not undergo surveillance, after accounting for the lead-time bias. […] Even though this study is not a randomized clinical trial, but we observed a 37% reduction in HCC mortality when ultrasound was used as a single tool for HCC surveillance as recommended by most widely accepted guidelines. […] Given the benefits of surveillance in improving survival and reducing mortality, it is important to enhance the surveillance rate by identifying barriers to surveillance, and developing strategies and effective intervention to overcome these obstacles.

• #59 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #60 Guideline for stratified screening and surveillance in patients with high risk of primary liver cancer (2020)

  https://www.oaepublish.com/articles/2394-5079.2021.13

  Differences continue to prevail in the definition of high-risk population of liver cancer and screening surveillance regimen in relevant guidelines for the diagnosis and treatment of liver cancer newly issued by the American Association for the Study of Liver Diseases (AASLD), European Association for the Study of the Liver (EASL), Korean Liver Cancer Association-National Cancer Center Korea, National Comprehensive Cancer Network (NCCN), European Society for Medical Oncology and Asian-Pacific Association for the Study of the Liver (APASL). In 2019, National Health Commission (NHC) of China updated the Guidelines for Diagnosis and Treatment of Primary Liver Cancer, which defined patients with chronic viral hepatitis, alcoholic and non-alcoholic hepatitis, and liver cirrhosis due to various causes as a high-risk population for liver cancer, and recommended abdominal ultrasonography (US) combined with serum alpha-fetoprotein (AFP) every 6 months as their surveillance regimen.

• #61 Hepatocellular Carcinoma Surveillance – Viral Hepatitis and Liver Disease

  https://www.hepatitis.va.gov/cirrhosis/complications/hcc-surveillance.asp

  Liver cancer surveillance is recommended for all patients with Child-Turcotte-Pugh (CTP) Class A and B cirrhosis and patients with CTP Class C cirrhosis listed for liver transplantation who are eligible for curative or palliative (surgical, locoregional, or systemic) therapies for hepatocellular carcinoma (HCC). […] HCC occurs most often (80% of the time) in patients with advanced fibrosis/cirrhosis. […] Screening (or more accurately, surveillance for this at-risk population) will result in earlier stage at diagnosis and greater chance of cure. […] Most guidelines call for ultrasound every 6 months with or without alpha-fetoprotein (AFP) screening in all patients with cirrhosis. […] The HCC guidelines published by the American Society for the Study of Liver Disease (AASLD) in 2018 recommend: Surveillance of adults with cirrhosis because it improves overall survival.

• #62 Regular checks for liver cancer (surveillance) – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/diagnosis-and-care/regular-checks-for-liver-cancer/

  Liver cancer is more common in people who have serious liver damage, but finding it early means it can often be cured. Doctors use regular checks called surveillance to help find cancer early. […] Most people with cirrhosis or long-term hepatitis B infection will be offered a clinical check-up every 6 months. These check-ups help your clinical team look after your liver health as well as giving any treatment you need such as anti-viral therapy for hepatitis B. And they normally include surveillance checks that look for signs of liver cancer. […] Because these checks aim to find liver cancer as soon as possible, its important to take part every time. Even if you feel okay. […] You will be invited for regular liver cancer checks if you have been diagnosed with cirrhosis. […] In some places in England there is an NHS pilot programme offering liver health checks to look for signs of liver disease in people who are at higher risk. People who have signs they could have serious liver damage may be referred for regular liver cancer checks.

• #63 Imaging Techniques for the Surveillance, Diagnosis, and Staging of Hepatocellular Carcinoma | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/liver-cancer/research-protocol

  The 2011 Annual Report to the Nation on the Status of Cancer reported that for the 5-year and 10-year periods analyzed, deaths from liver cancer have significantly increased from 1998-2007 and from 2003-2007 in both men and women. These new cases are mostly traceable to cirrhosis caused by either hepatitis B virus (HBV) or hepatitis C virus (HCV) infection or long-term alcohol abuse. The American Association for the Study of Liver Diseases (AASLD) has identified the following groups as being at high risk for developing HCC and recommends that these population groups undergo surveillance: Asian male HBV carriers over age 40, Asian female HBV carriers over age 50, HBV carriers with a family history of HCC, African/North American black HBV carriers, HBV or HCV carriers with cirrhosis, all individuals with other causes for cirrhosis (including alcoholic cirrhosis), and patients with stage 4 primary biliary cirrhosis.

• #64 Imaging Techniques for the Surveillance, Diagnosis, and Staging of Hepatocellular Carcinoma | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/liver-cancer/research-protocol

  The 2011 Annual Report to the Nation on the Status of Cancer reported that for the 5-year and 10-year periods analyzed, deaths from liver cancer have significantly increased from 1998-2007 and from 2003-2007 in both men and women. These new cases are mostly traceable to cirrhosis caused by either hepatitis B virus (HBV) or hepatitis C virus (HCV) infection or long-term alcohol abuse. The American Association for the Study of Liver Diseases (AASLD) has identified the following groups as being at high risk for developing HCC and recommends that these population groups undergo surveillance: Asian male HBV carriers over age 40, Asian female HBV carriers over age 50, HBV carriers with a family history of HCC, African/North American black HBV carriers, HBV or HCV carriers with cirrhosis, all individuals with other causes for cirrhosis (including alcoholic cirrhosis), and patients with stage 4 primary biliary cirrhosis.

• #65 Imaging Techniques for the Surveillance, Diagnosis, and Staging of Hepatocellular Carcinoma | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/liver-cancer/research-protocol

  The 2011 Annual Report to the Nation on the Status of Cancer reported that for the 5-year and 10-year periods analyzed, deaths from liver cancer have significantly increased from 1998-2007 and from 2003-2007 in both men and women. These new cases are mostly traceable to cirrhosis caused by either hepatitis B virus (HBV) or hepatitis C virus (HCV) infection or long-term alcohol abuse. The American Association for the Study of Liver Diseases (AASLD) has identified the following groups as being at high risk for developing HCC and recommends that these population groups undergo surveillance: Asian male HBV carriers over age 40, Asian female HBV carriers over age 50, HBV carriers with a family history of HCC, African/North American black HBV carriers, HBV or HCV carriers with cirrhosis, all individuals with other causes for cirrhosis (including alcoholic cirrhosis), and patients with stage 4 primary biliary cirrhosis.

• #66 Hepatocellular Carcinoma Surveillance – Viral Hepatitis and Liver Disease

  https://www.hepatitis.va.gov/cirrhosis/complications/hcc-surveillance.asp

  Surveillance using ultrasound, with or without AFP screening, every 6 months. […] No surveillance of patients with cirrhosis with CTP Class C unless they are on the transplant waiting list, given low anticipated survival for patients with this degree of hepatic dysfunction. […] Patients with chronic hepatitis B are at risk of liver cancer even in the absence of cirrhosis. […] Ultrasound surveillance is advised every 6 months in the following populations (regardless of stage of fibrosis): Patients with cirrhosis, African decent over 20 years of age, ALL males over 40 years of age, Asian females over 50 years of age. […] HCC is increasingly being reported in patients with nonalcoholic steatohepatitis (NASH) without cirrhosis; the pathogenesis of HCC in this population may be different than in the population with viral hepatitis; there are currently no recommendations for surveillance in this population.

• #67 Core Concepts – Surveillance for Hepatocellular Carcinoma – Evaluation, Staging, and Monitoring of Chronic Hepatitis C – Hepatitis C Online

  https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/surveillance-hepatocellular-carcinoma/core-concept/all

  The rationale for conducting HCC surveillance is that regular screening of asymptomatic persons at risk for HCC may detect tumors at an early stage when potentially curative treatment can be offered. Early detection of HCC is particularly important, given the very poor prognosis with lesions that are detected late. […] The 2023 AASLD HCC Guidance recommends all adults with cirrhosis of any etiology should have surveillance for HCC because surveillance improves survival and increases the detection of early-stage HCC. This guidance also emphasizes the importance of antiviral therapy in the prevention of HCC, noting the reduced risk of HCC in patients with sustained HBV viral suppression and HCV clearance. […] For persons with chronic HCV and cirrhosis, achievement of sustained virologic response (SVR) with direct-acting antiviral (DAA) therapy reduces the risk of HCC by 71 to 79%. Although the risk of HCV-related HCC decreases following successful treatment and cure of HCV, the risk of HCC is not eliminated. Accordingly, individuals with chronic HCV infection who are undergoing HCC surveillance should continue to do so, even if they achieve a sustained virologic response following treatment of HCV.

• #68 Core Concepts – Surveillance for Hepatocellular Carcinoma – Evaluation, Staging, and Monitoring of Chronic Hepatitis C – Hepatitis C Online

  https://www.hepatitisc.uw.edu/go/evaluation-staging-monitoring/surveillance-hepatocellular-carcinoma/core-concept/all

  The rationale for conducting HCC surveillance is that regular screening of asymptomatic persons at risk for HCC may detect tumors at an early stage when potentially curative treatment can be offered. Early detection of HCC is particularly important, given the very poor prognosis with lesions that are detected late. […] The 2023 AASLD HCC Guidance recommends all adults with cirrhosis of any etiology should have surveillance for HCC because surveillance improves survival and increases the detection of early-stage HCC. This guidance also emphasizes the importance of antiviral therapy in the prevention of HCC, noting the reduced risk of HCC in patients with sustained HBV viral suppression and HCV clearance. […] For persons with chronic HCV and cirrhosis, achievement of sustained virologic response (SVR) with direct-acting antiviral (DAA) therapy reduces the risk of HCC by 71 to 79%. Although the risk of HCV-related HCC decreases following successful treatment and cure of HCV, the risk of HCC is not eliminated. Accordingly, individuals with chronic HCV infection who are undergoing HCC surveillance should continue to do so, even if they achieve a sustained virologic response following treatment of HCV.

• #69 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #70 Hepatocellular Carcinoma Surveillance – Viral Hepatitis and Liver Disease

  https://www.hepatitis.va.gov/cirrhosis/complications/hcc-surveillance.asp

  Surveillance using ultrasound, with or without AFP screening, every 6 months. […] No surveillance of patients with cirrhosis with CTP Class C unless they are on the transplant waiting list, given low anticipated survival for patients with this degree of hepatic dysfunction. […] Patients with chronic hepatitis B are at risk of liver cancer even in the absence of cirrhosis. […] Ultrasound surveillance is advised every 6 months in the following populations (regardless of stage of fibrosis): Patients with cirrhosis, African decent over 20 years of age, ALL males over 40 years of age, Asian females over 50 years of age. […] HCC is increasingly being reported in patients with nonalcoholic steatohepatitis (NASH) without cirrhosis; the pathogenesis of HCC in this population may be different than in the population with viral hepatitis; there are currently no recommendations for surveillance in this population.

• #71 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #72 Burden of liver cancer: From epidemiology to prevention

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9829497/

  The optimal interval for the surveillance program plays a critical role in finding the curable stage of liver cancer. […] A multicenter randomized trial including patients with alcoholic cirrhosis comparing 3-month periodicity and 6-month period indicated that every 3 months period for ultrasonographic surveillance did not significantly increase the likelihood to detect small (3 cm) HCC. […] The burden of liver cancer in China contributes to nearly half of cases across the world but presents a decreasing trend over the past decade.

• #73 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #74 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #75 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #76 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #77 Addressing the worldwide hepatocellular carcinoma: epidemiology, prevention and management – Samant – Journal of Gastrointestinal Oncology

  https://jgo.amegroups.org/article/view/36868/html

  Systemic reviews demonstrate US alone has sensitivity for HCC from 30-70%. […] Zhang et al. in their landmark randomized control study in Chinese hepatitis B population reported 30% reduction in mortality with abdominal US and alpha-fetoprotein (AFP) every 6 months as screening strategy. […] At present, the concern is adherence to such surveillance program as data from Surveillance, Epidemiology, and End Results registry shows that less than 20% of patients who developed HCC had received regular surveillance. […] AFP alone should not be used as screening test due to low sensitivity. […] However, complete exclusion of AFP as cost effective screening tool is controversial and European Association for the Study of the Liver (EASL) and AASLD did recommend the use of US with AFP for surveillance.

• #78 Addressing the worldwide hepatocellular carcinoma: epidemiology, prevention and management – Samant – Journal of Gastrointestinal Oncology

  https://jgo.amegroups.org/article/view/36868/html

  Systemic reviews demonstrate US alone has sensitivity for HCC from 30-70%. […] Zhang et al. in their landmark randomized control study in Chinese hepatitis B population reported 30% reduction in mortality with abdominal US and alpha-fetoprotein (AFP) every 6 months as screening strategy. […] At present, the concern is adherence to such surveillance program as data from Surveillance, Epidemiology, and End Results registry shows that less than 20% of patients who developed HCC had received regular surveillance. […] AFP alone should not be used as screening test due to low sensitivity. […] However, complete exclusion of AFP as cost effective screening tool is controversial and European Association for the Study of the Liver (EASL) and AASLD did recommend the use of US with AFP for surveillance.

• #79 Addressing the worldwide hepatocellular carcinoma: epidemiology, prevention and management – Samant – Journal of Gastrointestinal Oncology

  https://jgo.amegroups.org/article/view/36868/html

  Systemic reviews demonstrate US alone has sensitivity for HCC from 30-70%. […] Zhang et al. in their landmark randomized control study in Chinese hepatitis B population reported 30% reduction in mortality with abdominal US and alpha-fetoprotein (AFP) every 6 months as screening strategy. […] At present, the concern is adherence to such surveillance program as data from Surveillance, Epidemiology, and End Results registry shows that less than 20% of patients who developed HCC had received regular surveillance. […] AFP alone should not be used as screening test due to low sensitivity. […] However, complete exclusion of AFP as cost effective screening tool is controversial and European Association for the Study of the Liver (EASL) and AASLD did recommend the use of US with AFP for surveillance.

• #80 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Therefore, there has been increasing interest in serum biomarkers that may improve sensitivity for early HCC detection. […] The global incidence and mortality of HCC is rising, particularly in the United States and Europe. Given the strong association between early detection and survival, improving uptake and performance of HCC surveillance must be defined as a priority for our community.

• #81 Liver Cancer Surveillance Is Life Saving [United States]

  https://healthcaresolutions-us.fujifilm.com/products/in-vitro-diagnostics/hcc-risk-biomarkers/liver-cancer-surveillance-life-saving/

  Liver cancer surveillance is the application of screening tests such as blood tests and ultrasonography at regular intervals, intended to identify liver cancer at an early stage in individuals who are at risk. […] Robust surveillance in high risk patients is critical to finding liver cancer in its early stage which is when more effective treatment options are available and can be applied with more success. […] Practice guidelines from the American Association for the Study of Liver Diseases (AASLD) and National Comprehensive Cancer Network (NCCN) recommend primary liver cancer surveillance by periodic screening (every 3-6 months) for patients at high-risk for liver cancer development. Collectively, evidence supports surveillance in high-risk groups. […] Elevated values in these blood tests (DCP or AFP-L3) have been shown to be associated with an increased risk of developing liver cancer.

• #82 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Implementation of infant HBV immunization programs in many countries in East Asia are expected to lower HBV-related HCC in the future. […] The evidence highlighting a survival benefit associated with HCC screening in patients with cirrhosis remains controversial. […] The only randomized controlled trial supporting HCC surveillance using abdominal ultrasound every 6 months was obtained from a trial performed in more than 18,000 Chinese patients and displayed a 37% reduction risk in mortality in screened patients. […] Western recommendations support a 6-month time frame for screening interval based on HCC volume doubling-time, which is estimated to be around 6 months. […] Abdominal ultrasound has been the historic cornerstone for HCC surveillance and continues to be recommended as the primary surveillance test by the AASLD, EASL, and APASL.

• #83 The Impact of National Surveillance for Liver Cancer: Results from Real-World Setting in Korea

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl18522

  The survival probability of the surveillance group was statistically higher throughout the entire follow-up period (p0.0001, Renyi test) as compared with the no-surveillance group. […] The mortality risk of patients who underwent the surveillance program once 2 years prior to the diagnosis of LC was 22.0% lower (HR, 0.78; 95% CI, 0.76 to 0.80) as compared with the patients who did not participate in the program.

• #84 Surveillance for Hepatocellular Carcinoma Reduces Mortality: an Inverse Probability of Treatment Weighted Analysis | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-surveillance-for-hepatocellular-carcinoma-reduces-S1665268119304156

  We found that patients in the surveillance program had a significantly better survival than those who did not undergo surveillance, after accounting for the lead-time bias. […] Even though this study is not a randomized clinical trial, but we observed a 37% reduction in HCC mortality when ultrasound was used as a single tool for HCC surveillance as recommended by most widely accepted guidelines. […] Given the benefits of surveillance in improving survival and reducing mortality, it is important to enhance the surveillance rate by identifying barriers to surveillance, and developing strategies and effective intervention to overcome these obstacles.

• #85

• #86 Hepatocellular Carcinoma: Surveillance, Diagnosis, Evaluation and Management

  https://www.mdpi.com/2072-6694/15/21/5118

  Hepatocellular carcinoma (HCC) is the most common primary liver cancer. High-risk patients should undergo semi-annual surveillance. Management of HCC is complex and requires multidisciplinary team evaluation and the consideration of patient’s goals of care. Early HCC is best managed by curative-intent treatment with liver resection, transplantation, or ablation. Intermediate-stage disease may be treated with transarterial therapies. Advanced-stage disease should be treated with systemic therapy. There are many therapies and therapy combinations currently under investigation. […] Hepatocellular carcinoma (HCC) ranks fourth in cancer-related deaths worldwide. Semiannual surveillance of the disease for patients with cirrhosis or hepatitis B virus allows for early detection with more favorable outcomes. The current underuse of surveillance programs demonstrates the need for intervention at both the patient and provider level.

• #87 Barriers to surveillance for hepatocellular cancer among patients with chronic liver disease -providers’ perspectives

  https://www.oaepublish.com/articles/2394-5079.2023.75

  Most cases of HCC occur in patients with known risk factors for HCC, including chronic hepatitis B and cirrhosis from hepatitis B (HBV), hepatitis C (HCV), heavy alcohol use and non-alcoholic steatohepatitis, as well as other chronic liver diseases. […] Studies have demonstrated that high-risk patients who undergo surveillance are diagnosed with earlier-stage HCC, are more likely to receive potentially curative treatment such as surgical resection or liver transplantation, and have improved survival in comparison with those patients who presented with associated symptoms or incidental detection of HCC and may only qualify for locoregional therapies and/or systemic treatment. […] Therefore, expert society guidelines recommend HCC surveillance every 6 months for high-risk individuals. Nonetheless, less than 20% of patients in the US with cirrhosis undergo routine surveillance.

• #88 Hepatocellular Carcinoma: Surveillance, Diagnosis, Evaluation and Management

  https://www.mdpi.com/2072-6694/15/21/5118

  Although the HCC surveillance of patients with cirrhosis has been found to increase survival, surveillance is underused in clinical practice. Barriers have been identified at the patient level, provider level, and system level. […] Due to the continued underuse of surveillance programs, it is recommended that interventions be implemented to improve HCC surveillance rates. A variety of interventions have been evaluated.

• #89 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  The low HCC survival rate is largely due to delayed diagnosis, because people remain asymptomatic during the early stages of HCC and clinical examination and investigations might not detect any abnormalities. This often delays the detection of the tumour(s) until advanced stages. To mediate this, HCC surveillance is recommended in high-risk populations, such as patients with liver cirrhosis and/or chronic hepatitis B. HCC surveillance consists of liver ultrasound scans (USS), preferably with the serum biomarker -fetoprotein (AFP), performed every six months. Despite recommendations, HCC surveillance rates have remained low. […] A meta-analysis on the utilisation of HCC surveillance for cirrhotic patients in the US reported a pooled rate of just 18.4%. However, utilisation rates were sixfold higher when provided within a surveillance program (eg reminder systems) compared to usual care.

• #90 Improved surveillance may help reduce the HCC mortality rate

  https://www.oncoguardliver.com/news-and-research/hepatocellular-carcinoma-high-mortality-rate-improved-surveillance-may-help-reduce

  Hepatocellular carcinoma (HCC) is the most common form of liver cancer. Its also the fastest growing cause of cancer-related deaths in the United States. […] The American Cancer Society estimates that more than 40,000 new cases of HCC, occurring mostly in men, will be diagnosed in 2021. […] Hepatocellular carcinoma can be challenging to detect early because its signs and symptoms often do not appear until the more advanced stages of cancer. […] Despite these challenges, it is imperative to discover HCC as early as possible while curative treatment approaches are still available to the patient. […] Surveillance for HCC is underutilized. […] In the United States, only one third of the estimated 3 million patients who meet the criteria for surveillance receive it. […] We envision a future where people at high risk for HCC are not only promptly identified but encouraged and given support to help them adhere to a routine HCC surveillance program. […] Were also committed to developing a surveillance tool with high sensitivity to enable early-stage detection of HCC, thereby giving patients the chance to undergo potentially curative treatments.

• #91 NHS England » Hepatocellular carcinoma surveillance: minimum standards

  https://www.england.nhs.uk/long-read/hepatocellular-carcinoma-surveillance-minimum-standards/

  Liver cancer is the fastest-rising cause of cancer related deaths in the UK. The most common form of primary liver cancer is hepatocellular carcinoma (HCC), which makes up 85% of all liver cancers. […] According to Cancer Research UK, around 6,200 people are diagnosed with liver cancer each year. Incidence of HCC has increased by 50% over the past decade and is expected to continue to rise. Existing evidence suggests that only around 20% of HCCs are currently diagnosed at an early stage (stages 1 or 2). […] National Institute for Health and Care Excellence (NICE) guidance recommends that people at high risk of HCC (those with hepatitis B and/or cirrhosis) receive 6-monthly liver surveillance (NG50, CG165, CG115). And while guidelines from NICE and the European Association for the Study of the Liver recommend HCC surveillance, fewer than half of patients who should receive surveillance actually do.

• #92 Podcast Recap: Barriers to Liver Cancer Surveillance – Hepatitis B Foundation

  https://www.hepb.org/blog/podcast-recap-barriers-liver-cancer-surveillance/

  Liver cancer screening is also not included in the United States Preventative Services Taskforce (USPSTF), which is a tool used by most providers in the U.S. to recommend preventative services to their patients. […] For people living with chronic hepatitis B, many are not aware of the link between the virus and liver cancer. […] For many people who need liver cancer screening, they have limited access to care (loss to follow-up, lack of health insurance coverage, etc.). […] It is crucial to make sure patients are aware of the link between hepatitis B and liver cancer, the role of screening in early diagnosis and prevention of advanced tumors, and the importance of monitoring liver health as recommended by liver societies and guidelines on liver cancer surveillance.

• #93 Barriers to surveillance for hepatocellular cancer among patients with chronic liver disease -providers’ perspectives

  https://www.oaepublish.com/articles/2394-5079.2023.75

  Recent studies have also shown disparities in rates of surveillance, eligibility for surgical intervention, and survival in HCC patients with similar clinical characteristics in the United States. Important barriers at the patient, provider and system levels have been identified. […] However, limited studies have been performed evaluating provider-reported barriers to HCC surveillance. […] Therefore, the current qualitative study aimed to identify patient-, provider-, and system-level barriers to surveillance for HCC among high-risk patients from providers perspectives in the United States and to examine provider knowledge and attitudes related to HCC surveillance. Additionally, we explored interventions providers suggested that could improve HCC surveillance rates. […] Several important themes emerged from interview data, including: (1) Provider comfort with managing chronic liver disease and the relationships between hepatology, gastroenterology, infectious disease, and primary care providers; (2) Provider knowledge of guidelines for HCC surveillance in high-risk patients and their knowledge about the impact that HCC surveillance can have; (3) How providers discuss HCC surveillance with their high-risk patients; (4) Provider-Level barriers to surveillance; (5) System-level barriers to surveillance; (6) COVID-19; (7) Patient-level barriers to surveillance; and (8) Suggested interventions to improve HCC surveillance rates. […] In designing interventions to improve HCC surveillance rates of high-risk patients in the United States, there are important targets at the patient, provider and system levels.

• #94 Podcast Recap: Barriers to Liver Cancer Surveillance – Hepatitis B Foundation

  https://www.hepb.org/blog/podcast-recap-barriers-liver-cancer-surveillance/

  Liver cancer screening is also not included in the United States Preventative Services Taskforce (USPSTF), which is a tool used by most providers in the U.S. to recommend preventative services to their patients. […] For people living with chronic hepatitis B, many are not aware of the link between the virus and liver cancer. […] For many people who need liver cancer screening, they have limited access to care (loss to follow-up, lack of health insurance coverage, etc.). […] It is crucial to make sure patients are aware of the link between hepatitis B and liver cancer, the role of screening in early diagnosis and prevention of advanced tumors, and the importance of monitoring liver health as recommended by liver societies and guidelines on liver cancer surveillance.

• #95 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  Primary care providers (PCP) play an important role in disease prevention and management, and are generally the first point of contact patients have with the health system. In the context of HCC surveillance, PCPs have a crucial role in diagnosing and managing viral hepatitis infections and cirrhosis, two of the key risks for HCC. Therefore, PCPs might also play an important role in conducting surveillance for HCC. […] Many studies have evaluated the effectiveness of HCC surveillance in the primary care setting. Several of these have attributed underutilisation of surveillance to both patient (eg poor adherence, cost) and PCP (lack of awareness of surveillance guidelines) factors. […] This is the first systematic review of the evidence for HCC surveillance in primary care settings. We found that irrespective of HCC risk factors, surveillance rates were consistently lower for patients managed by PCPs compared with gastroenterologists or hepatologists. When additional support was provided to PCPs to address a range of barriers, surveillance rates increased substantially.

• #96

• #97 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  HCC surveillance is of critical importance in reducing morbidity and mortality for high-risk populations. For CHB patients with cirrhosis, the annual risk of developing HCC is 35%, and 0.42% in the absence of cirrhosis. […] Barriers to HCC surveillance included lack of knowledge and awareness of HCC and associated risk factors. A key barrier identified was PCP lack of awareness of surveillance recommendations. Many professional societies have published HCC surveillance recommendations. These recommendations are critically important to support clinical decision making; therefore, awareness of these guidelines and improving knowledge of HCC and relevant aetiologies must form part of a strategy to improve HCC surveillance in primary care settings. […] This systematic review found that primary care-based HCC surveillance programs are most likely to be effective if PCPs are supported (eg recall systems, clinician education or reminder systems), programs are of low or no cost to patients, abdominal imaging and pathology are easily accessible and information is communicated to all treating HCPs and patients in a timely manner.

• #98 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  HCC surveillance is of critical importance in reducing morbidity and mortality for high-risk populations. For CHB patients with cirrhosis, the annual risk of developing HCC is 35%, and 0.42% in the absence of cirrhosis. […] Barriers to HCC surveillance included lack of knowledge and awareness of HCC and associated risk factors. A key barrier identified was PCP lack of awareness of surveillance recommendations. Many professional societies have published HCC surveillance recommendations. These recommendations are critically important to support clinical decision making; therefore, awareness of these guidelines and improving knowledge of HCC and relevant aetiologies must form part of a strategy to improve HCC surveillance in primary care settings. […] This systematic review found that primary care-based HCC surveillance programs are most likely to be effective if PCPs are supported (eg recall systems, clinician education or reminder systems), programs are of low or no cost to patients, abdominal imaging and pathology are easily accessible and information is communicated to all treating HCPs and patients in a timely manner.

• #99 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  In Australia, mortality rates for hepatocellular carcinoma (HCC) are rising. Targeted surveillance is recommended to increase early diagnosis. The aim of this study was to synthesise evidence regarding HCC surveillance in primary care and identify barriers and facilitators to surveillance. […] HCC surveillance rates were lower for patients managed by primary care providers (PCPs) than for those managed by gastroenterologists/hepatologists. HCC surveillance rates increased when additional support was provided to PCPs (eg reminder systems, nurse follow-up). Key barriers were a lack of awareness of HCC risks and surveillance recommendations, as well as competing priorities PCPs must address when working with patients with multimorbidity. […] Globally, liver cancer is the seventh most frequently occurring cancer and the second most common cause of cancer mortality. Incidence and mortality rates for liver cancer have increased rapidly in Australia; since the mid-1980s, the age-standardised incidence rate has increased by more than 300% and the mortality rate has increased by almost 200%. Hepatocellular carcinoma (HCC) is the most common form of liver cancer, accounting for 85% of cases.

• #100 Podcast Recap: Barriers to Liver Cancer Surveillance – Hepatitis B Foundation

  https://www.hepb.org/blog/podcast-recap-barriers-liver-cancer-surveillance/

  In a recent episode on the B Heppy podcast, Dr. Neehar Parikh, a hepatologist at the University of Michigan, discussed the link between hepatitis B and liver cancer, barriers to screening for liver cancer, and screening methods for liver cancer. […] Hepatitis B can cause liver cancer, especially when left untreated or unmonitored. […] This is why doctors recommend patients living with hepatitis B to continue to monitor their liver health and take treatment if necessary to prevent the progression to liver cancer. […] It is recommended to get liver cancer screening (usually through an ultrasound that looks at damaged tissue or abnormal cell growth) once every six months. […] There are several barriers to liver cancer screening at the provider and patient levels. […] Providers are also not always following recommendations or guidelines from liver societies on hepatitis B management and liver cancer surveillance.

• #101 Barriers to surveillance for hepatocellular cancer among patients with chronic liver disease -providers’ perspectives

  https://www.oaepublish.com/articles/2394-5079.2023.75

  Recent studies have also shown disparities in rates of surveillance, eligibility for surgical intervention, and survival in HCC patients with similar clinical characteristics in the United States. Important barriers at the patient, provider and system levels have been identified. […] However, limited studies have been performed evaluating provider-reported barriers to HCC surveillance. […] Therefore, the current qualitative study aimed to identify patient-, provider-, and system-level barriers to surveillance for HCC among high-risk patients from providers perspectives in the United States and to examine provider knowledge and attitudes related to HCC surveillance. Additionally, we explored interventions providers suggested that could improve HCC surveillance rates. […] Several important themes emerged from interview data, including: (1) Provider comfort with managing chronic liver disease and the relationships between hepatology, gastroenterology, infectious disease, and primary care providers; (2) Provider knowledge of guidelines for HCC surveillance in high-risk patients and their knowledge about the impact that HCC surveillance can have; (3) How providers discuss HCC surveillance with their high-risk patients; (4) Provider-Level barriers to surveillance; (5) System-level barriers to surveillance; (6) COVID-19; (7) Patient-level barriers to surveillance; and (8) Suggested interventions to improve HCC surveillance rates. […] In designing interventions to improve HCC surveillance rates of high-risk patients in the United States, there are important targets at the patient, provider and system levels.

• #102 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  HCC surveillance is of critical importance in reducing morbidity and mortality for high-risk populations. For CHB patients with cirrhosis, the annual risk of developing HCC is 35%, and 0.42% in the absence of cirrhosis. […] Barriers to HCC surveillance included lack of knowledge and awareness of HCC and associated risk factors. A key barrier identified was PCP lack of awareness of surveillance recommendations. Many professional societies have published HCC surveillance recommendations. These recommendations are critically important to support clinical decision making; therefore, awareness of these guidelines and improving knowledge of HCC and relevant aetiologies must form part of a strategy to improve HCC surveillance in primary care settings. […] This systematic review found that primary care-based HCC surveillance programs are most likely to be effective if PCPs are supported (eg recall systems, clinician education or reminder systems), programs are of low or no cost to patients, abdominal imaging and pathology are easily accessible and information is communicated to all treating HCPs and patients in a timely manner.

• #103 Podcast Recap: Barriers to Liver Cancer Surveillance – Hepatitis B Foundation

  https://www.hepb.org/blog/podcast-recap-barriers-liver-cancer-surveillance/

  Liver cancer screening is also not included in the United States Preventative Services Taskforce (USPSTF), which is a tool used by most providers in the U.S. to recommend preventative services to their patients. […] For people living with chronic hepatitis B, many are not aware of the link between the virus and liver cancer. […] For many people who need liver cancer screening, they have limited access to care (loss to follow-up, lack of health insurance coverage, etc.). […] It is crucial to make sure patients are aware of the link between hepatitis B and liver cancer, the role of screening in early diagnosis and prevention of advanced tumors, and the importance of monitoring liver health as recommended by liver societies and guidelines on liver cancer surveillance.

• #104

• #105 Liver cell cancer surveillance practice in Nigeria: Pitfalls and future prospects

  https://www.wjgnet.com/1948-5182/full/v16/i10/1132.htm

  Hepatocellular carcinoma (HCC) is a disease of public health concern in Nigeria, with chronic hepatitis B and C infections contributing most to the disease burden. […] Despite the increasing incidence of HCC, surveillance practices for early diagnosis and possible cure are not deeply rooted in the country. […] This article aims to review the current status of HCC surveillance in Nigeria, stressing the encounters, breaches, and potential prospects. […] Several factors, such as limited tools for screening and diagnostics, insufficient infrastructure, and low cognizance among the doctors, and the general public affect the surveillance practices for HCC in Nigeria. […] Moreover, the lack of standardized guidelines and protocols for HCC surveillance further intensifies the suboptimal diagnosis and treatment.

• #106

• #107 Liver cell cancer surveillance practice in Nigeria: Pitfalls and future prospects

  https://www.wjgnet.com/1948-5182/full/v16/i10/1132.htm

  HCC surveillance in high-risk individuals is necessary for early detection to increase the chances of curative treatment and survival. […] Emerging blood-based biomarkers such as the Gender, Age, L3 fraction of AFP and DCP score, liquid biopsy techniques, and the rapidly developing Artificial Intelligence technology are considered and promoted in the developed world. […] These may greatly improve individualized HCC risk prediction and interpretation of imaging techniques. […] The reliability and challenges of various HCC surveillance methods should be improved with enhanced sensitivity and specificity to provide a lasting solution for poor uptake. […] Given the current context, integrating internationally recognized surveillance methods tailored to Nigeria’s unique healthcare landscape is paramount for addressing this challenge.

• #108 Imaging Techniques for the Surveillance, Diagnosis, and Staging of Hepatocellular Carcinoma | Effective Health Care (EHC) Program

  https://effectivehealthcare.ahrq.gov/products/liver-cancer/research-protocol

  Surveillance strategies for HCC use available imaging techniques alone or in a particular sequence. For example, some centers use ultrasound (US) alternatively with either computed tomography (CT) or magnetic resonance imaging (MRI) every 6 months. Some of these strategies also make use of variations that represent evolving technologies, such as the use of liver-specific MRI contrast agents such as gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) and superparamagnetic iron oxide (SPIO), dual energy CT, and newer fluorodeoxyglucose positron emission tomography (FDG-PET) tracers such as 18F-fluorothymidine (FLT), 11C-choline, and 11C-methionine. […] In addition to imaging tests, biomarkers for HCC have also been used in surveillance and diagnosis. Alpha-fetoprotein is the most widely used serological marker for HCC, but it is recommended only as an adjunct to imaging. Another HCC biomarker is des-gamma-carboxy prothrombin; however, this marker has been evaluated in patients with late-stage HCC only, and its role in relation to imaging for the surveillance and early diagnosis of HCC is unknown. Other biomarkers include glypican 3, heat shock protein 70, and glutamine synthetase. The use of glypican 3, heat shock protein 70, and glutamine synthase have not been validated in the clinical setting.

• #109 Liver cell cancer surveillance practice in Nigeria: Pitfalls and future prospects

  https://www.wjgnet.com/1948-5182/full/v16/i10/1132.htm

  HCC surveillance in high-risk individuals is necessary for early detection to increase the chances of curative treatment and survival. […] Emerging blood-based biomarkers such as the Gender, Age, L3 fraction of AFP and DCP score, liquid biopsy techniques, and the rapidly developing Artificial Intelligence technology are considered and promoted in the developed world. […] These may greatly improve individualized HCC risk prediction and interpretation of imaging techniques. […] The reliability and challenges of various HCC surveillance methods should be improved with enhanced sensitivity and specificity to provide a lasting solution for poor uptake. […] Given the current context, integrating internationally recognized surveillance methods tailored to Nigeria’s unique healthcare landscape is paramount for addressing this challenge.

• #110 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20241125/Mursla-Bios-EvoLiver-surpasses-current-standards-in-liver-cancer-surveillance-data-presented-at-AASLD-Liver-Meeting-2024.aspx

  Mursla Bio, a leader in Extracellular Vesicle (EV) science on a mission to significantly improve cancer outcomes for at-risk patients through the power of dynamic biopsy technology, today announced results of its multi-center clinical study, MEV01, in collaboration with leading academic institutes including University College London, Imperial College London, University Hospital of Santa Maria and the Medical University of Graz. The ongoing study is investigating the Company’s dynamic biopsy-based blood test, EvoLiver, for the surveillance of primary liver cancer, Hepatocellular Carcinoma (HCC), among high-risk, cirrhotic patients. Mursla Bio established the first EV multiomics biomarker signature for HCC with 86% early-stage sensitivity and 88% specificity, significantly surpassing existing surveillance techniques including ultrasound and alpha-fetoprotein testing.

• #111 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  The low HCC survival rate is largely due to delayed diagnosis, because people remain asymptomatic during the early stages of HCC and clinical examination and investigations might not detect any abnormalities. This often delays the detection of the tumour(s) until advanced stages. To mediate this, HCC surveillance is recommended in high-risk populations, such as patients with liver cirrhosis and/or chronic hepatitis B. HCC surveillance consists of liver ultrasound scans (USS), preferably with the serum biomarker -fetoprotein (AFP), performed every six months. Despite recommendations, HCC surveillance rates have remained low. […] A meta-analysis on the utilisation of HCC surveillance for cirrhotic patients in the US reported a pooled rate of just 18.4%. However, utilisation rates were sixfold higher when provided within a surveillance program (eg reminder systems) compared to usual care.

• #112 Surveillance for liver cancer in primary care: A systematic review of the evidence

  https://www1.racgp.org.au/ajgp/2023/november/surveillance-for-liver-cancer-in-primary-care

  HCC surveillance is of critical importance in reducing morbidity and mortality for high-risk populations. For CHB patients with cirrhosis, the annual risk of developing HCC is 35%, and 0.42% in the absence of cirrhosis. […] Barriers to HCC surveillance included lack of knowledge and awareness of HCC and associated risk factors. A key barrier identified was PCP lack of awareness of surveillance recommendations. Many professional societies have published HCC surveillance recommendations. These recommendations are critically important to support clinical decision making; therefore, awareness of these guidelines and improving knowledge of HCC and relevant aetiologies must form part of a strategy to improve HCC surveillance in primary care settings. […] This systematic review found that primary care-based HCC surveillance programs are most likely to be effective if PCPs are supported (eg recall systems, clinician education or reminder systems), programs are of low or no cost to patients, abdominal imaging and pathology are easily accessible and information is communicated to all treating HCPs and patients in a timely manner.

• #113 Liver cell cancer surveillance practice in Nigeria: Pitfalls and future prospects

  https://www.wjgnet.com/1948-5182/full/v16/i10/1132.htm

  Nevertheless, there are opportunities for refining surveillance practices in the country. […] This would be achieved through boosted public health sensitization campaigns, integrating HCC screening into routine clinical services, and leveraging technological developments for early detection and monitoring. […] Furthermore, collaboration between government agencies, healthcare providers, and international organizations can facilitate the development of comprehensive HCC surveillance programs personalized to the Nigerian setting. […] Thus, HCC surveillance practice faces substantial challenges. […] By addressing the drawbacks and leveraging prospects, Nigeria can improve HCC surveillance, with subsequent improved outcomes for individuals at risk of developing the disease. […] HCC is a preventable disease with a poor prognosis and high mortality especially when presented late.

• #114 Barriers to surveillance for hepatocellular cancer among patients with chronic liver disease -providers’ perspectives

  https://www.oaepublish.com/articles/2394-5079.2023.75

  Recent studies have also shown disparities in rates of surveillance, eligibility for surgical intervention, and survival in HCC patients with similar clinical characteristics in the United States. Important barriers at the patient, provider and system levels have been identified. […] However, limited studies have been performed evaluating provider-reported barriers to HCC surveillance. […] Therefore, the current qualitative study aimed to identify patient-, provider-, and system-level barriers to surveillance for HCC among high-risk patients from providers perspectives in the United States and to examine provider knowledge and attitudes related to HCC surveillance. Additionally, we explored interventions providers suggested that could improve HCC surveillance rates. […] Several important themes emerged from interview data, including: (1) Provider comfort with managing chronic liver disease and the relationships between hepatology, gastroenterology, infectious disease, and primary care providers; (2) Provider knowledge of guidelines for HCC surveillance in high-risk patients and their knowledge about the impact that HCC surveillance can have; (3) How providers discuss HCC surveillance with their high-risk patients; (4) Provider-Level barriers to surveillance; (5) System-level barriers to surveillance; (6) COVID-19; (7) Patient-level barriers to surveillance; and (8) Suggested interventions to improve HCC surveillance rates. […] In designing interventions to improve HCC surveillance rates of high-risk patients in the United States, there are important targets at the patient, provider and system levels.

• #115 LIVER CANCER SURVEILLANCE IN THE VA: IMPLEMENTATION-EFFECTIVENESS STEPPED-WEDGE CLUSTER-RANDOMIZED TRIAL | AASLD

  https://www.aasld.org/the-liver-meeting/liver-cancer-surveillance-va-implementation-effectiveness-stepped-wedge-cluster

  AASLD and EASL guidelines recommend all people with cirrhosis undergo twice yearly screening for hepatocellular carcinoma (HCC) with hepatic imaging. […] This stepped-wedge hybrid effectiveness-implementation trial assessed the impacts of using a quality improvement playbook called Getting to Implementation (GTI) to support VA facilities to select, implement, and evaluate data-driven strategies to improve HCC surveillance. […] The primary implementation outcome was GTI completion and strategy implementation. The secondary clinical outcome was receipt of guideline-concordant HCC surveillance at baseline, post-intervention, and sustainment. […] HCC surveillance improved from 21% at baseline to 30% during intervention and remained elevated at 32% during sustainment. […] Generalized linear mixed models indicated significant changes in HCC surveillance during both implementation (aOR=1.306; 95% CI: [1.159, 1.472], p0.0001) and sustainment (aOR versus control=1.511; 95% CI: [1.315, 1.73], p-value 0.0001).

• #116 LIVER CANCER SURVEILLANCE IN THE VA: IMPLEMENTATION-EFFECTIVENESS STEPPED-WEDGE CLUSTER-RANDOMIZED TRIAL | AASLD

  https://www.aasld.org/the-liver-meeting/liver-cancer-surveillance-va-implementation-effectiveness-stepped-wedge-cluster

  Sustainment, a challenge for implementation trials, was significantly associated with improvement in HCC surveillance compared with active implementation (aOR=1.168; 95% CI: [1.018, 1.340], p-value 0.0271). […] Data-driven strategies with facilitated quality improvement sustainably improved HCC surveillance in Veterans with cirrhosis receiving care in the lowest-performing VA facilities.

• #117 JMIR Public Health and Surveillance – Development of a Prediction Model and Risk Score for Self-Assessment and High-Risk Population Identification in Liver Cancer Screening: Prospective Cohort Study

  https://publichealth.jmir.org/2024/1/e65286

  Compared to the low-risk group, participants in the high-risk and moderate-risk groups had 11.88-fold (95% CI 8.67-16.27) and 3.51-fold (95% CI 2.58-4.76) higher risks of liver cancer, respectively. […] A straightforward liver cancer prediction model was created by incorporating easily accessible variables. This model enables the identification of asymptomatic individuals who should be prioritized for liver cancer screening. […] The epidemiology of liver cancer is characterized by significant demographic variations. Age is a well-known risk factor for liver cancer. […] Our study showed that individuals with diabetes had a 2.08-fold higher risk of liver cancer. […] Regular screening for liver cancer is recommended for individuals with cirrhosis, as early detection can improve treatment outcomes. […] Our study provides a valuable model for identifying high-risk populations for liver cancer, which can be effectively used in screening and surveillance efforts.

• #118 Guideline for stratified screening and surveillance in patients with high risk of primary liver cancer (2020)

  https://www.oaepublish.com/articles/2394-5079.2021.13

  The incidence and mortality of PLC are low in European and American areas, but have gradually increased in the past 10-year; the incidence of PLC is high in Asian population, but both incidence and mortality are decreasing year-by-year. […] In 2018, GLOBOCAN reported an ASR incidence of 17.7/100,000 for PLC and the ASR mortality as 16.4/100,000 in the Chinese population, both of which ranked ninth in the world. […] The total incidents and death cases of PLC accounted for about half of the worlds cases each year, with significant urban-rural and regional differences; the population-adjusted incidence in rural area was 20.07/100,000 and the mortality was 17.52/100,000, higher than the incidence (16.13/100,000) and mortality (13.64/100,000) in urban areas. […] Therefore, a stratified management of high-risk population of liver cancer may be the most important strategy to improve its early diagnosis and cost-effectiveness.

• #119 Cost-effectiveness of monitoring and liver cancer surveillance among patients with inactive chronic hepatitis B | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0313898

  Patients with chronic hepatitis B infection (CHB) have an increased risk for death from liver cirrhosis and hepatocellular carcinoma (HCC). […] The AASLD also recommends HBsAg positive individuals with an annual HCC risk greater than 0.2% per year to receive hepatocellular carcinoma (HCC) surveillance with biannual liver ultrasound with or without blood levels of alfa-fetoprotein (AFP). […] The current study found regular monitoring of the thousands of adults diagnosed with inactive or immune tolerant CHB in the United States who are initially not recommended for treatment and subsequently receive antiviral therapy when indicated is cost-saving. […] The addition of HCC surveillance with the standard recommendation for biannual ultrasound and AFP would be cost-effective if the HCC risk is 0.55% per year such as patients with cirrhosis who have an estimated HCC incidence of over 3%/yr. […] A possible alternate lower cost HCC surveillance strategy consisting of only an annual ultrasound and biannual AFP would be cost-effective and could be considered for patients who have a lower HCC risk (0.3%/yr) including Asian men over 40 years and Asian women over 50 years.

• #120 JMIR Public Health and Surveillance – Development of a Prediction Model and Risk Score for Self-Assessment and High-Risk Population Identification in Liver Cancer Screening: Prospective Cohort Study

  https://publichealth.jmir.org/2024/1/e65286

  Background: Liver cancer continues to pose a significant burden in China. To enhance the efficiency of screening, it is crucial to implement population stratification for liver cancer surveillance. […] This study aimed to develop a simple prediction model and risk score for liver cancer screening in the general population, with the goal of improving early detection and survival. […] Key factors identified for the prediction model and risk score system included age (hazard ratio [HR] 1.06, 95% CI 1.04-1.08), sex (male: HR 3.41, 95% CI 2.44-4.78), education level (medium: HR 0.84, 95% CI 0.61-1.15; high: HR 0.37, 95% CI 0.17-0.78), cirrhosis (HR 11.93, 95% CI 7.46-19.09), diabetes (HR 1.59, 95% CI 1.08-2.34), and hepatitis B surface antigen (HBsAg) status (positive: HR 3.84, 95% CI 2.38-6.19; unknown: HR 1.04, 95% CI 0.73-1.49).

• #121 Liver cell cancer surveillance practice in Nigeria: Pitfalls and future prospects

  https://www.wjgnet.com/1948-5182/full/v16/i10/1132.htm

  Nevertheless, there are opportunities for refining surveillance practices in the country. […] This would be achieved through boosted public health sensitization campaigns, integrating HCC screening into routine clinical services, and leveraging technological developments for early detection and monitoring. […] Furthermore, collaboration between government agencies, healthcare providers, and international organizations can facilitate the development of comprehensive HCC surveillance programs personalized to the Nigerian setting. […] Thus, HCC surveillance practice faces substantial challenges. […] By addressing the drawbacks and leveraging prospects, Nigeria can improve HCC surveillance, with subsequent improved outcomes for individuals at risk of developing the disease. […] HCC is a preventable disease with a poor prognosis and high mortality especially when presented late.

• #122

• #123 Hepatocellular Carcinoma Clinical Guidelines | Cancer Council

  https://www.cancer.org.au/clinical-guidelines/liver-cancer/hepatocellular-carcinoma

  The NHMRC-approved guidelines aim to provide information and recommendations to guide surveillance for people at high risk of HCC. Evidence has shown it to be successful in detecting lesions and/or early-stage tumours, increasing the receipt of curative treatment and improving overall survival […] Launched in June 2023, the Roadmap aims to reduce the liver cancer disease burden, improve outcomes and improve survival rates for all Australians affected by liver cancer over the next two, five, and ten years. Identifying key priorities that will pave the most efficient and effective way forward and setting a shared agenda to drive improvements in liver cancer care, experience and outcomes.

• #124 The Impact of National Surveillance for Liver Cancer: Results from Real-World Setting in Korea

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl18522

  Primary liver cancer (LC) is one of the most common cancers in 2012, accounting for 9.1% of all cancer worldwide and the second most common cause of death from cancer worldwide and same in South Korea. […] HCC meets all the criteria established by the World Health Organization (WHO) for performing surveillance on those at risk for developing cancer. […] The prevalence of hepatitis B virus and hepatitis C virus infections in Asia, well known risk factors for HCC, is higher than Western counterparts. […] In Korea, the national surveillance program for LC was established in 2003. In this program, repeated applications of diagnostic tests (AFP and US) at 6-month intervals were recommended in patients at high risk for developing HCC, such as men and women older than 40 years of age with positive hepatitis B surface antigen, anti-hepatitis C virus antibody, or underlying liver cirrhosis.

• #125 Epidemiology and Surveillance for Hepatocellular Carcinoma: New Trends

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6986771/

  Therefore, there has been increasing interest in serum biomarkers that may improve sensitivity for early HCC detection. […] The global incidence and mortality of HCC is rising, particularly in the United States and Europe. Given the strong association between early detection and survival, improving uptake and performance of HCC surveillance must be defined as a priority for our community.

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