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Hepatocellular carcinoma surveillance — ABIM Board MCQ

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ModerateGastroenterology/HepatologyHepatocellular carcinoma surveillanceABIM Board

A 59-year-old with compensated cirrhosis from previously cured hepatitis C has no focal liver lesion and remains a treatment candidate. Should hepatocellular-carcinoma surveillance continue?

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

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Correct answer: D — Continue liver ultrasound with alpha-fetoprotein approximately every six months

The best answer is “Continue liver ultrasound with alpha-fetoprotein approximately every six months”. HCV cure reduces but does not eliminate HCC risk once cirrhosis is established. Ultrasound with AFP about every six months balances tumor-growth biology and test performance. AFP alone is insufficient, and chest CT or repeated colonoscopy does not survey the liver.

Reference: AASLD Practice Guidance on Hepatocellular Carcinoma: https://www.aasld.org/practice-guidelines/management-hepatocellular-carcinoma