Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia: summary of recommendations
Year: 2025
Type: article
Abstract: INTRODUCTION: Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer, the sixth most common cause of cancer death in Australia. With shifting aetiologies and a growing at-risk population, consistent routine surveillance recommendations are key to early detection of HCC and improved survival. We developed new evidence-based HCC surveillance guidelines for people at high risk in Australia due to liver disease and/or other risk factors. These guidelines were developed by a working group of experts in liver cancer control and included evidence reviews, synthesis and adaptation of existing guidelines for the Australian context, and predictive modelling. MAIN RECOMMENDATIONS: This article summarises the recommendations and practice points for key population subgroups who were identified as potentially benefitting from routine HCC surveillance in the form of six-monthly ultrasound scans, with or without α-fetoprotein testing. People with liver cirrhosis and a non-HCC-related life expectancy of greater than six months are recommended to receive routine HCC surveillance. People with chronic hepatitis B virus infection who do not have liver cirrhosis are recommended to receive routine HCC surveillance if they have a family history of HCC, are Aboriginal or Torres Strait Islander peoples, or have an Asian, Pacific, or sub-Saharan African background, with varying start ages recommended for each group. People with stage 3 non-cirrhotic liver fibrosis (F3) may be recommended to receive routine HCC surveillance based on individual risk assessment, or otherwise monitored for progression to cirrhosis. The final guidelines were approved by the National Health and Medical Research Council (NHMRC) in April 2023. CHANGES IN MANAGEMENT AS A RESULT OF THE GUIDELINE: The updated guidelines formalise recommendations for people with cirrhosis, identify other patient groups who are recommended for surveillance, and highlight gaps in evidence where the benefit of surveillance is unclear. These guidelines were accompanied by the Roadmap to liver cancer control, a coordinated ten-year plan for advancing liver cancer prevention and early detection in Australia. The full guidelines can be accessed at https://cancer.org.au/clinical-guidelines/liver-cancer/hepatocellular-carcinoma.
Source: The Medical Journal of Australia
DOI: 10.5694/mja2.70061
Authors: Jacob George, Nicole L Allard, Stuart K Roberts, Leon A Adams, Jane Davies, Behzad Hajarizadeh, Jennifer H MacLachlan, Suzanne E Mahady, Rosalie Altus, Catherine Brown, David C Fry, Belinda Greenwood‐Smith, Natali Smud, Patricia C Valery, Nafisa Yussf, Kate Broun, Denise Campbell, Karen Canfell, Chelsea Carle Harrison, Victoria Freeman, Paul Grogan, Catherine Holliday, Suzanne Hughes, Anna Kelly, Cathelijne van Kemenade, Claire Latumahina, Amanda McAtamney, Megan Varlow, Joachim Worthington, Susan Yuill, Eleonora Feletto
Institutions: The University of Sydney, Westmead Institute for Medical Research, The University of Melbourne, Peter Doherty Institute, The Alfred Hospital, Monash University, The University of Western Australia, Sir Charles Gairdner Hospital, Menzies School of Health Research, Royal Darwin Hospital, UNSW Sydney, Kirby Institute, Flinders Medical Centre, Government of the Northern Territory, Sydney Local Health District, QIMR Berghofer Medical Research Institute, Cancer Council Victoria, Cancer Council NSW, University College London, Cancer Council Australia
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,400
OpenAlex ID: W4414398218