Monitoring risk before symptoms appear
Hepatocellular carcinoma, or HCC, can develop in some people with cirrhosis and selected patients with chronic hepatitis B. Surveillance aims to identify cancer when effective treatment may still be possible. It is not a routine test for everyone with a mildly abnormal liver enzyme result.
What does surveillance involve?
For eligible patients, monitoring usually involves liver ultrasound approximately every six months, often with AFP according to the chosen protocol. AFP alone is not an adequate surveillance strategy. Poor ultrasound visibility or a suspicious result may require an alternative test or diagnostic CT or MRI.
An abnormal result is not a diagnosis by itself
A lesion or raised AFP needs interpretation with imaging and clinical risk. Treatment decisions may involve liver, radiology, surgical or transplant specialists. Successful hepatitis treatment does not automatically end surveillance when significant residual risk remains.
Keep your monitoring organised
Ask whether you qualify for surveillance, which tests are planned, the due date and how results will be reviewed. Bring previous images as well as reports when possible. A missed appointment should prompt contact with the clinical team, not an assumption that the next test can be delayed indefinitely.
New severe pain, increasing jaundice, bleeding, confusion or rapid abdominal swelling needs medical assessment regardless of the next scheduled surveillance date. Suitability for surveillance depends on overall health, liver disease and whether a detected cancer could be treated.
Professional reference: AASLD guidance on HCC surveillance and management. Liver care · Arrange a review.