Surveillance for early diagnosis of hepatocellular carcinoma: How best to do it?

Table 1 Suggested thresholds of hepatocellular carcinoma incidence for the implementation of surveillance[15]

Group of patients	Threshold incidence to implement surveillance (% per year)	Incidence of HCC
Surveillance recommended
Asian male hepatitis B carriers over age 40	0.2	0.4%-0.6%/yr
Asian female hepatitis B carriers over age 50	0.2	0.3%-0.6%/yr
Hepatitis B carriers with family history of hepatocellular carcinoma	0.2	Incidence higher than without family history
African/North American Blacks with hepatitis B	0.2	Hepatocellular carcinoma occurs at a younger age
Hepatitis B virus carriers, cirrhosis	0.2-1.5	3%-8%/yr
Hepatitis C virus infection, cirrhosis	1.5	3%-5%/yr
Primary Biliary Cirrhosis, stage 4	1.5	3%-5%/yr
Genetic hemochromatosis, cirrhosis	1.5	Unknown, but probably > 1.5%/yr
Alpha 1-antitrypsin deficiency, cirrhosis	1.5	Unknown, but probably > 1.5%/yr
Other cirrhosis	1.5	Unknown
Surveillance benefit uncertain
Hepatitis B carriers younger than 40 (males) or 50 (females)	0.2	< 0.2%/yr
Hepatitis C virus infection, stage 3 fibrosis	1.5	< 1.5%/yr
Non-cirrhotic non-alcoholic fatty liver disease	1.5	< 1.5%/yr

HCC: Hepatocellular carcinoma.