Digestive Diseases and Sciences

, Volume 64, Issue 4, pp 903–909 | Cite as

Changing Epidemiology of HCC: How to Screen and Identify Patients at Risk?

  • Naomi Lange
  • Jean-François DufourEmail author


The prognosis of patients with hepatocellular carcinoma is dependent on the stage of tumor at diagnosis. The earlier the tumor is found, the higher the chances to offer a curative treatment. In order to diagnose hepatocellular carcinoma early, patients at risk should be enrolled in a surveillance program. The population at risk is usually defined as patients with cirrhosis. These patients should have twice a year a ultrasonographic examination of the liver. However, more and more patients will develop hepatocellular carcinoma in the context of nonalcoholic fatty liver disease which is tightly linked to obesity and diabetes. In these patients, this approach is jeopardized by the difficulty to perform a sonography of good quality due to the obesity and more importantly by the fact that hepatocellular carcinoma occurs frequently in the context of nonalcoholic fatty liver disease before the cirrhosis. This article reviews the impact of the changing epidemiology of hepatocellular carcinoma on its screening.


Hepatocellular carcinoma Liver cancer Surveillance Population at risk Epidemiology 


Compliance with ethical standards

Conflict of interest

Naomi Lange do not have any conflicts of interest to disclose. Jean-François Dufour served as advisory committees in Abbvie, Bayer, BMS, Falk, Genfit, Genkyotex, Gilead Science, Intercept, Lilly, Novartis.


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Authors and Affiliations

  1. 1.Department of General Internal MedicineInselspital-Bern University HospitalBernSwitzerland
  2. 2.Hepatology, Department of Visceral Surgery and MedicineInselspital-Bern University HospitalBernSwitzerland
  3. 3.Department of Biomedical ResearchUniversity of BernBernSwitzerland

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