Prevention & Screening
Worldwide, the majority of HCC is associated with chronic hepatitis B virus infection. Today, however, all newborns are vaccinated against hepatitis B in China and other Asian countries. Therefore, the frequency of chronic HBV in future generations will decrease. Eventually, perhaps in three or four generations, HBV will be totally eradicated, thereby eliminating the most common risk factor for HCC.
Some retrospective (looking back in time) studies suggest that patients with chronic hepatitis C who were treated with interferon were less likely to develop HCC than patients who were not treated. Interestingly, in these studies, interferon treatment seemed to provide this benefit, even to patients who had less than an optimal antiviral response to interferon. Still, it remains to be seen whether the risk of developing cirrhosis and HCC is significantly decreased in prospectively (looking ahead) followed patients who responded to interferon.
Screening patients at high risk for HCC allows for the most options for treatment, including liver resection and liver transplantation. Patients at high risk for HCC include:
- Patients with cirrhosis
- Patients with underlying hepatitis B with or without cirrhosis
- Patients with exposures to certain carcinogenic substances such as aflatoxin
- Patients with cirrhosis, particularly cirrhosis caused by chronic hepatitis B or C, hemochromatosis, and alcohol, should be screened at 6 to 12 month intervals. The major screening tools include:
- CT - Computed Tomography
- MRI - Magnetic Resonance Imaging
- Image Guided Liver Biopsy