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Abstract Details
We need stronger evidence for (or against) hepatocellular carcinoma surveillance
J Hepatol. 2021 Jan 16;S0168-8278(21)00020-9. doi: 10.1016/j.jhep.2020.12.029.Online ahead of print.
Peter Jepsen1, Joe West2
Author information
1Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom. Electronic address: pj@clin.au.dk.
2Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom; NIHR Nottingham Biomedical Research Centre (BRC), Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, United Kingdom.
Abstract
Current guidelines from EASL recommend that most patients with cirrhosis are offered surveillance for hepatocellular carcinoma (HCC), but fewer than expected patients actually receive it. The recommendation is based on observational studies and simulations, not randomized trials. In this opinion piece we argue that a randomized trial of HCC surveillance vs. no surveillance is necessary and feasible, and we believe that clinician and patient participation in HCC surveillance would be better if it were based on trial results demonstrating its value.