Hepatocellular Cancer

Question 1

What is the screening test of choice and frequency of screening for patients considered high risk for HCC?

Answer 1

U/S q6m

AFP monitoring IS NOT recommended unless U/S unavailable.

Question 2

Which patients require screening for HCC?

Answer 2

1. All patients with cirrhosis, irrespective of etiology - except for Childs Pugh C that are not expected to be on the transplant list.
2. Hepatitis B Carriers WITH HIGH RISK features.

Question 3

What are the high risk features in patients with chronic HBV that warrant HCC screening (6)?

Answer 3

1. Asian Male > or = 40
2. Asian Female > or = 50
3. African or North American Blacks > or = 20 years old.
4. Family history of HCC in a FDR (starting at age 40 years old)
5. All HIV co-infected patients (starting at age 40)
6. All HDV co-infected patients.