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Hepatocellular Carcinoma: State of the Art - missing is
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Post HCV Cure Surveillance in Patients with Cirrhosis !
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AASLD nov 4-8 2022
We need NOW to be aggressive about prevention, early detection & treatment.
we see a rising mortality rate in men & women, one of the few cancers in which we see this. If these trends continue HCC is projected to be 3rd leading cause of death by 2035.
the AT RISK POPULATION we need to target are those with cirrhosis OR at risk for cirrhosis.
BUT there is some risk to get HCC without having cirrhosis in HBV & NASH. But only in HBV do we recommend HCC screening without having first cirrhosis.
Cirrhosis creates an identifiable at-risk population.
EARLY DETECTION IS KEY TO SURVIVAL
IMPORTANCE OF SCREENING
#! patients with CIRRHOSIS cured by DAAs who are SILL at risk for HCC & MUST continue regular screening BUT do NOT - we see years later many of these patients coming up with large HCCs no longer treatable. ULTRASOUND + AFP - this is new recommendation in GUidance for this group for continued surveillance.
Many prefer using MRI instead of ultrasound, they think its BETTER.
25% of patients with cirrhosis are screened
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