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Cohort study
Danish patients with alcoholic cirrhosis have a low risk of hepatocellular carcinoma thus raising questions about the utility of screening
  1. Jamile’ Wakim-Fleming1,
  2. Rocio Lopez2
  1. 1Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
  2. 2Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, USA
  1. Correspondence to: Jamile’ Wakim-Fleming
    Department of Gastroenterology, and Hepatology, Cleveland Clinic Foundation, 9500 Euclid Avenue, A/51, Cleveland, OH 44195, USA; fleminj1{at}ccf.org

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Alcohol consumption is increasing worldwide.1 As this trend continues, so is the associated morbidity and mortality.2 ,3 Alcohol causes cirrhosis and hepatocellular carcinoma (HCC). Amount and duration of consumption are the two most important risk factors.3 ,4 The incidence rates for HCC have tripled during the past decades5 and alcoholic cirrhosis is a major contributing factor. Abstinence improves survival.4

Most HCC in alcoholics occur in cirrhosis. Surveillance is recommended when HCC risk exceeds 1.5% per year and the cost is <$50 000/year of life gained. Guidelines state that alcoholic cirrhosis is probably sufficient to warrant …

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