Introducing HCC Surveillance in the Central Denmark Region
This study aims to investigate whether repeated 6-monthly screening for hepatocellular carcinoma (HCC) - called HCC surveillance - offered to selected patients with chronic liver disease can reduce HCC-related mortality by facilitating earlier detection of HCC. The screening procedure consists of two tests: an ultrasound examination of the liver and a blood sample to measure alpha-fetoprotein. Patients who screen positive on either examination will be offered standard work-up for HCC, typically beginning with a CT-scan. In the study HCC surveillance will be offered to all patients with compensated non-viral cirrhosis residing in the Central Denmark Region, one of five administrative regions of Denmark. The study aims to determine the efficacy of HCC surveillance in reducing HCC-related mortality by comparing HCC-related mortality between the Central Denmark Region and the other four Danish regions, where HCC surveillance is not offered.
• Cirrhosis
• No history of chronic hepatitis B or C
• Compensated cirrhosis defined as:
⁃ No recent variceal bleeding, no uncontrolled ascites, no clinically apparent hepatic encephalopathy, and Child-Pugh score ≤ 8
• Age 40-79 years
• Expected remaining life expectancy ≥ 1 year
• Not already in follow-up after treatment for HCC
• No clinical suspicion of HCC