Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 39: Which Patients With Chronic Liver Disease Should I Screen For Hepatocellular Carcinoma? (continued)

Douglas M. Heuman, MD; Adil Habib, MD

In our practice we recommend that patients with established cirrhosis of any cause undergo screening for hepatocellular carcinoma (HCC)*. We also screen patients who have lesser degrees of liver fibrosis on biopsy if there is evidence of portal hypertension (for example, thrombocytopenia or splenomegaly) or compromised liver function (abnormal albumin, INR, or bilirubin), since biopsy can sometimes underestimate severity of liver disease. Finally, we screen for hepatocellular carcinoma in adult patients with longstanding chronic hepatitis B infection regardless of the severity of liver…