Q) Which of the following is true about screening in hepatocellular carcinoma (HCC Cancer)
a) Alpha feto protein should be done 6 monthly
b) Ultrasound abdomen should be done 6 monthly
c) Candidates for liver transplant should be screened every 3 months
d) Nodules more than 2 cm should be followed up more regularly
In a cirrhotic liver, hcc cancer can develop any time and a stringent screening protocols have to be followed for early detection and timely treatment. Earlier ultrasound of liver and alpha feto protein were both used as tumor markers. However in 2009 Marrero et al demonstrated the suboptimal accuracy of AFP and after that it has been removed from the screening protocol and now only ultrasound is being done.
The screening recommendation is not for those patients with severe associated conditions and with advanced liver disease who are already considered for transplant. So there is no screening for those who are already listed.Nodules more than 1 cm are highly suspicious where as in nodules less than 1 cm only 40% will be malignant.
Ref: blumgart 6th edition