Screening for Hepatocellular Carcinoma: The Role of Alpha-fetoprotein and Ultrasound with and without Ultrasound Contrast Agents

Abstract

The increasing incidence of hepatocellular carcinoma (HCC) is becoming a considerable problem in the UK and worldwide. Although there is no national surveillance programme, increasing evidence shows that surveillance programmes may be beneficial and potentially cost-effective. Small, non-symptomatic HCCs that could be detected on regular ultrasound screening are amenable to treatment, including liver transplantation, surgical resection and radio frequency ablation with good 5-year survival rates. However, large tumours, greater than 5 cm, have a poor prognosis and treatment is only palliative. Therefore, the identification of small lesions through a formalized liver ultrasound surveillance programme together with serum alpha-fetoprotein (AFP) may be useful.