Current Hepatology Reports

, Volume 18, Issue 4, pp 383–389 | Cite as

Harms of Hepatocellular Carcinoma Surveillance

  • Jan Petrasek
  • Amit G. Singal
  • Nicole E. RichEmail author
Hepatic Cancer (N Parikh, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hepatic Cancer


Purpose of Review

Hepatocellular carcinoma (HCC) surveillance in patients with cirrhosis is associated with decreased mortality by enabling early tumor detection. However, the benefits of any cancer screening program must be considered in light of potential physical, financial, and psychological harms, as well as the risk of overdiagnosis. Herein, we summarize the potential harms of HCC surveillance.

Recent Findings

To date, two retrospective studies have addressed physical harms of HCC surveillance. Based on these data, 15% to 28% of patients undergoing HCC surveillance experience physical harm including additional cross-sectional imaging or liver biopsy. Although psychological and financial harms have been reported for other cancers, there are currently limited data specific to HCC. An ongoing multi-center prospective study assessing all four types of harms should provide data in the near future.


HCC screening may improve survival by diagnosing tumors at an early stage, but limited sensitivity and specificity of screening tests can result in unintended harms. There is a need for further quality data evaluating both the benefits and harms of HCC surveillance.


Hepatocellular cancer Screening Risks Overdiagnosis 



American Association for the Study of Liver Diseases




Computed tomography


Hepatocellular carcinoma


European Association for the Study of the Liver


Magnetic resonance imaging


Nonalcoholic steatohepatitis


National Comprehensive Cancer Network


Authors’ Contributions

Jan Petrasek: Concept and design, drafting of the manuscript

Amit G. Singal: Concept and design, drafting of the manuscript

Nicole E. Rich: Concept and design, drafting of the manuscript

All authors approved the final version of this manuscript.

Funding Information

Amit Singal’s research is supported by the National Cancer Institute R01 CA212008 and R01 CA222900.

Compliance with Ethical Standards

Conflict of Interest

Amit Singal has been on advisory boards and served as a consultant for Wako Diagnostics, Roche, Exact Sciences, Glycotest, Bayer, Eisai, BMS, and Exelixis.

Jan Petrasek and Nicole E. Rich each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Jan Petrasek
    • 1
  • Amit G. Singal
    • 1
  • Nicole E. Rich
    • 1
    Email author
  1. 1.Division of Digestive and Liver Diseases, Department of Internal MedicineUT Southwestern Medical CenterDallasUSA

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