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BRCA1 Cancer Surveillance — RACP Adult Medicine MCQ

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HardHaematologyBRCA1 Cancer SurveillanceRACP Adult Medicine

A 63-year-old achieved sustained virological response after hepatitis C treatment but had established cirrhosis before therapy. Liver function is compensated and the latest ultrasound is normal. What surveillance strategy is appropriate?

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Correct answer: E — Continue six-monthly ultrasound-based hepatocellular-carcinoma surveillance despite virological cure

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

B is correct. Viral cure lowers but does not eliminate HCC risk once cirrhosis is established, so six-monthly ultrasound-based surveillance continues. A and E incorrectly assume risk disappears. C routine CT adds radiation/contrast and is reserved for inadequate ultrasound or diagnostic work-up. D AFP alone lacks sufficient sensitivity and specificity.

Reference: Medical Journal of Australia, Australian hepatocellular-carcinoma consensus recommendations: https://www.mja.com.au/journal/2021/214/10/australian-recommendations-management-hepatocellular-carcinoma-consensus