Surveillance for hepatocellular carcinoma in chronic liver disease: Evidence and controversies

Table 2 Comparison of recommendations regarding hepatocellular carcinoma surveillance in guidelines

Characteristics	AASLD guideline[19]	EASL guideline[20]	APASL guideline[21]
Recommended target population	Cirrhotic HBV and HCV patients	Cirrhotic patients with Child-Pugh stage A and B	Cirrhotic HBV and HCV patients
	Alcoholic cirrhosis	Cirrhotic patients with Child-Pugh stage C awaiting liver transplantation
	Stage 4 primary biliary cirrhosis	Non-cirrhotic HBV carriers with active hepatitis or family history of HCC
	Cirrhosis due to genetic hemochromatosis	Non-cirrhotic patients with chronic hepatitis C and advanced liver fibrosis F3
	Cirrhosis due to α 1-antitrypsin deficiency
	HBV carriers of Asian origin (male > 40 yr, female > 50 yr)
	African/North American Blacks with hepatitis B
	HBV carriers with family history of HCC
Surveillance benefit uncertain	HBV carriers younger than 40 (males) or
	50 (females)
	Hepatitis C and stage 3 fibrosis
	Non-cirrhotic NAFLD
Surveillance modality	US	US	US and AFP
Interval (mo)	6	6	6

AASLD: American Association for Study of Liver Disease; APASL: Asian Pacific Association for the Study of the Liver; HBV: Hepatitis B virus; HCV: Hepatitis C virus; NAFLD: Non-alcoholic fatty liver disease; US: Ultrasound, AFP: α-fetoprotein; HCC: Hepatocellular carcinoma; EASL: European Association for the Study of the Liver.