title: Screening and surveillance for hepatocellular carcinoma: perspective of a new era?
abstract: Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third most common cause of cancer-related death with an increasing prevalence worldwide. Early diagnosis of HCC is important since observational studies have reported that, in patients undergoing surveillance, cancer is diagnosed at an earlier stage with increased chances of curative therapies. Anyway, despite the extensive use of screening for HCC, its effectiveness is still a controversial topic since supporting evidence is not unequivocal and some issues need to be explored. Areas covered: The aim of this paper is to review main literature data supporting performance and effectiveness of screening for early detection of hepatocellular carcinoma. Expert commentary: Clinical benefit of screening for HCC is controversial and there are no sufficient data supporting its effectiveness in reducing cancer specific mortality. Since it is unlikely that RCTs will be performed in the future, surveillance should be still reasonably recommended in all at-risk population, until potential data against its effectiveness will be provided. In the future additional and more effective non-invasive tests will be needed, as well as proper surveillance intervals and risk threshold for surveillance enrollment must be assessed and refined by prospective studies.
authors.affiliation: a Section of Gastroenterology , Villa Sofia, V. Cervello Hospital , Palermo , Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Maida
authors.affiliation: a Section of Gastroenterology , Villa Sofia, V. Cervello Hospital , Palermo , Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Malizia
authors.affiliation: b Section of Internal Medicine , Villa Sofia, V. Cervello Hospital , Palermo , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Affronti
authors.affiliation: b Section of Internal Medicine , Villa Sofia, V. Cervello Hospital , Palermo , Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Virdone
authors.affiliation: c Section of Internal Medicine, DIBIMIS , University of Palermo , Palermo , Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Maida
authors.affiliation: d Department of Medical Sciences, Surgical and Advanced Technologies , University of Catania , Catania , Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Margherita
authors.affiliation: a Section of Gastroenterology , Villa Sofia, V. Cervello Hospital , Palermo , Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: D'amico
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008403:Mass Screening / Q000379:methods*; D009367:Neoplasm Staging; D011159:Population Surveillance; D016032:Randomized Controlled Trials as Topic
keywords: BCLC; HCC; Hepatocellular carcinoma; screening; surveillance