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Systematic review with meta-analysis
Surveillance for hepatocellular carcinoma with ultrasound and AFP is associated with improvements in tumour detection, receipt of curative therapy and overall survival in patients with cirrhosis
  1. Danielle A Bischof,
  2. Timothy M Pawlik
  1. Department of Surgery, The Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to: Dr Timothy M Pawlik, Department of Surgery, The Johns Hopkins University, 600 N. Wolfe Street, Blalock 665, Baltimore, MD 21287, USA; tpawlik1{at}

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Hepatocellular carcinoma (HCC) represents a significant global health burden: HCC is the third most common cause of cancer death worldwide.1 Established risk factors for HCC include chronic liver disease, hepatitis B viral infection, hepatitis C viral infection and inherited metabolic diseases.2 Surveillance for HCC using ultrasound is recommended by the American Association for the Study of Liver Diseases (AASLD) in all patients with cirrhosis, starting at the time of diagnosis.3 This recommendation is supported by a single randomised controlled trial in which surveillance for HCC in patients with chronic hepatitis B infection improved early stage detection of HCC, rates of resection of HCC and overall survival.4 There are, however, no randomised trials examining the role of surveillance for HCC in patients with cirrhosis. This systematic review with meta-analysis examines the association of HCC surveillance in patients having cirrhosis with …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.