TY - JOUR
T1 - Surveillance for Hepatocellular Carcinoma
T2 - Current Best Practice and Future Direction
AU - Kanwal, Fasiha
AU - Singal, Amit G.
N1 - Funding Information:
Funding Dr Kanwal's research is supported by the US Department of Veterans Affairs Center for Innovations in Quality, Effectiveness and Safety (CIN 13-413), Michael E. DeBakey VA Medical Center, Houston, Texas, and the Center for Gastrointestinal Development, Infection and Injury (National Institute of Diabetes and Digestive and Kidney Diseases P30 DK 56338) and National Cancer Institute U01 CA230997. Dr Singal's research is supported by National Cancer Institute RO1 CA222900, RO1 CA212008, and U01 CA 230694. The content is solely the responsibility of the authors and does not necessarily represent the official views of the US Department of Veterans Affairs or the National Institutes of Health.
Publisher Copyright:
© 2019 AGA Institute
PY - 2019/7
Y1 - 2019/7
N2 - Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States. The overall prognosis of HCC remains dismal, except for the subset of patients who are diagnosed at early stage and receive potentially curative therapies, such as surgical resection and liver transplantation. Given this, expert society guidelines recommend HCC surveillance every 6 months in at-risk individuals. Despite these recommendations, the effectiveness of HCC surveillance remains a subject of debate. We discuss current best practices for HCC surveillance and the evidence that support these recommendations. We also describe several initiatives that are underway to improve HCC surveillance and outline areas that may serve as high-yield targets for future research. Overall, we believe these efforts will help the field move toward precision surveillance, where surveillance tests and intervals are tailored to individual HCC risk. Doing so can maximize surveillance benefits, minimize surveillance harms, and optimize overall value for all patients.
AB - Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States. The overall prognosis of HCC remains dismal, except for the subset of patients who are diagnosed at early stage and receive potentially curative therapies, such as surgical resection and liver transplantation. Given this, expert society guidelines recommend HCC surveillance every 6 months in at-risk individuals. Despite these recommendations, the effectiveness of HCC surveillance remains a subject of debate. We discuss current best practices for HCC surveillance and the evidence that support these recommendations. We also describe several initiatives that are underway to improve HCC surveillance and outline areas that may serve as high-yield targets for future research. Overall, we believe these efforts will help the field move toward precision surveillance, where surveillance tests and intervals are tailored to individual HCC risk. Doing so can maximize surveillance benefits, minimize surveillance harms, and optimize overall value for all patients.
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U2 - 10.1053/j.gastro.2019.02.049
DO - 10.1053/j.gastro.2019.02.049
M3 - Review article
C2 - 30986389
AN - SCOPUS:85067207897
VL - 157
SP - 54
EP - 64
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 1
ER -