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HCC Surveillance in Cirrhosis — RACP Adult Medicine MCQ

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EasyGastroenterology & HepatologyHCC Surveillance in CirrhosisRACP Adult Medicine

A 58-year-old man with cirrhosis develops an acute variceal bleed. After resuscitation and octreotide infusion, endoscopy confirms grade III varices with active bleeding. Band ligation is performed successfully. He has never had a variceal bleed before. When should he be screened for hepatocellular carcinoma?

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Correct answer: D — Every 2 years

All patients with cirrhosis (regardless of aetiology) should undergo 6-monthly HCC surveillance with liver ultrasound (with or without AFP). This has been shown to detect HCC at an earlier, more treatable stage and improve survival. The AASLD, EASL, and Australian guidelines universally recommend 6-monthly surveillance. The presence of a variceal bleed does not change the HCC screening schedule but confirms advanced portal hypertension requiring ongoing comprehensive cirrhosis care.

Reference: Cancer Council Australia – 2020 – HCC Guidelines; GESA – 2020 – Cirrhosis Management