Hepatocellular carcinoma surveillance

Hepatocellular carcinoma related mortality is one of the highest among all cancers. Ninety percent of all hepatocellular carcinoma develop in the context of liver cirrhosis. Liver cirrhosis is not recognized prior to the diagnosis of hepatocellular carcinoma in 25 % of the cases, despite the existence of risk factors. Hepatocellular carcinoma is diagnosed within a surveillance program in less than 25 % of the cases. Ultrasound screening for hepatocellular carcinoma every 6 months increases chances to diagnose HCC at an early stage amenable to curative treatment, and increases survival. Interval greater than 7 months between ultrasound imaging has a significant negative impact on survival. All patients diagnosed with cirrhosis have to perform an ultrasound screening for hepatocellular carcinoma and comply with the six months rule.