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Haemochromatosis HCC — SCE Medical Oncology MCQ

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HardGI CancersHaemochromatosis HCCSCE Medical Oncology

A man with HFE C282Y homozygous haemochromatosis has achieved iron depletion by venesection but has established cirrhosis. Which hepatocellular-carcinoma strategy remains indicated?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Continue six-monthly hepatic ultrasound, with or without AFP

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · E = shown as D · B = shown as E

B is correct. NICE recommends six-monthly ultrasound, with or without AFP, for people with cirrhosis who do not have hepatitis B. Removing excess iron reduces ongoing injury but does not reverse the established cirrhotic field risk sufficiently to stop surveillance. Repeated CT adds radiation and contrast exposure and is not the routine first-line surveillance test; AFP alone lacks sensitivity and specificity. Transplantation is considered for decompensated liver disease or qualifying HCC, not prophylactically for genotype or previous iron overload.

Reference: NICE NG50 cirrhosis recommendations: https://www.nice.org.uk/guidance/ng50/chapter/recommendations