Hepatocellular carcinoma is often curable when found early and rarely once it presents with symptoms, so surveillance is what makes the difference.
The established practice is six-monthly abdominal ultrasound, with or without alpha-fetoprotein, in patients with cirrhosis of any cause, and in selected high-risk hepatitis B carriers even without cirrhosis. Treat it as a recurring programme with active recall rather than a one-off scan — the benefit comes from consistent repetition — and investigate any new or enlarging nodule promptly with contrast-enhanced imaging.
- Offer six-monthly ultrasound, with or without AFP, to patients with cirrhosis of any cause.
- Include high-risk hepatitis B carriers without cirrhosis, per local criteria.
- Run surveillance as a recurring programme with active recall, not a single test.
- Investigate any new or enlarging nodule promptly with contrast-enhanced imaging.
Why it matters
HCC is curable when caught early and rarely once symptomatic, and the benefit depends on consistent repeat surveillance.
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