HCC screening in patients with chronic liver diseases

Hepatocellular carcinoma (HCC) is a frequent complication in patients with chronic liver diseases. Particular patients with advanced fibrosis or liver cirrhosis and patients with chronic hepatitis B virus infection are at high risk for HCC. As patients with advanced HCC have a poor prognosis and curative therapeutic options are only available in early stages, an early detection of HCC is of high importance. Patients with an increased risk for HCC development should undergo abdominal ultrasound for early detection of HCC every 6 months. A still unsolved problem is the massive increase in non-alcoholic fatty liver dis-ease (NAFLD) resulting from diabetes, overweight and physical inactivity, affecting approximately 30% of the population. The identification of patients with non-alcoholic steatohepatitis (NASH) who have an increased risk of HCC and who should be included in an early screening program, will be one of the biggest challenges in the coming years.