New AASLD Guidelines for Hepatocellular Carcinoma: The Big Questions Tackled

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Title : New AASLD Guidelines for Hepatocellular Carcinoma: The Big Questions Tackled
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New AASLD Guidelines for Hepatocellular Carcinoma: The Big Questions Tackled

COMMENTARY
New AASLD Guidelines for Hepatocellular Carcinoma: The Big Questions Tackled

David A. Johnson, MD
February 21, 2018

View video and read the complete article at Medscape

Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia.

When we see patients with cirrhosis in the clinic, we are concerned about screening for hepatocellular carcinoma (HCC). I'm not a transplant hepatologist, but I deal with these patients all the time, as you do.

HCC is an incredibly common disease. It's the fifth most common tumor in the world and the second leading cause of cancer-related death.[1] In the United States, there are an estimated 39,000 new cases per year and over 27,000 related deaths[2,3]; the incidence is likely to rise at least until 2030.[4] This problem is not going away.


Why is that? It's about cirrhosis. The majority of HCCs, 85%-95%, occur in patients with cirrhosis[5,6]—the exception to the rule being hepatitis B, where patients do not need to be cirrhotic. The incidence of HCC in patients with cirrhosis that I quote to my patients is 2%-4% per year.[7] Thus, it is recommended that we screen these patients because early screening may lead to earlier diagnosis and appropriate interventions.

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