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Review
. 2020 Feb;72(2):250-261.
doi: 10.1016/j.jhep.2019.08.025.

Epidemiology and surveillance for hepatocellular carcinoma: New trends

Amit G Singal  1 , Pietro Lampertico  2 , Pierre Nahon  3
Affiliations
Review

Epidemiology and surveillance for hepatocellular carcinoma: New trends

Amit G Singal et al. J Hepatol. 2020 Feb.

Abstract

The burden of hepatocellular carcinoma (HCC) is highest in East Asia and Africa, although its incidence and mortality are rapidly rising in the United States and Europe. With the implementation of hepatitis B vaccination and hepatitis C treatment programmes worldwide, the epidemiology of HCC is shifting away from a disease predominated by viral hepatitis - an increasing proportion of cases are now attributable to non-alcoholic steatohepatitis. Surveillance using ultrasound, with or without alpha-fetoprotein, every 6 months has been associated with improved early detection and improved overall survival; however, limitations in implementation lead to a high proportion of HCC being detected at late stages in clinical practice. Herein, we review the current state of HCC surveillance and highlight areas for future research, including improved risk stratification of at-risk patients, surveillance tools with higher sensitivity and specificity for early HCC, and interventions to increase surveillance utilisation.

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Conflict of interest statement

Conflicts of Interest:

Amit G. Singal has has served on advisory boards for Gilead, Abbvie, Bayer, Eisai, Bristol Meyers Squibb, Wako Diagnostics, and Exact Sciences. He serves as a consultant to Bayer, Eisai, Exelixis, Roche, Exact Sciences, Glycotest, and TARGET. He has received research funding from Gilead and Abbvie.

Pietro Lampertico has no relevant conflicts of interest

Pierre Nahon has received honoraria from and/or consults for Abbvie, Astra-Zeneca, Bayer, Bristol-Myers Squibb, Gilead, Ipsen and MSD. He received research grants from Abbvie and Bristol-Myers Squibb.

Figures

Figure 1.
Figure 1.
Worldwide Age-standardized HCC Incidence Rates, 2018
Figure 2.
Figure 2.
Potential Interventions to Increase HCC Surveillance Effectiveness
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