Established practice is to offer surveillance for hepatocellular carcinoma to people with cirrhosis, using liver ultrasound with or without alpha-fetoprotein every six months. Surveillance finds tumours when curative treatment is still possible, so it should continue even when the patient feels well.
When surveillance is missed, the cancer is often found late, and treatment options are then limited.
- Offer liver ultrasound, with or without alpha-fetoprotein, every six months in cirrhosis.
- Record the date of the last ultrasound in the notes.
- Chase missed appointments, since attendance is the weak link.
- Include people with hepatitis B at risk of cancer according to local guidance.
- Refer promptly for any new lesion.
Why it matters
Cancer found by surveillance is more often treatable than cancer found by symptoms.
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