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Hepatocellular carcinoma surveillance — RCPSC IM MCQ

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HardGastroenterology/HepatologyHepatocellular carcinoma surveillanceRCPSC IM

A 58-year-old man with compensated cirrhosis from cured hepatitis C attends follow-up. Platelets are 94 x 10^9/L, albumin is 37 g/L, bilirubin is 18 umol/L and ultrasound 6 months ago was negative. He feels well and has no ascites. What is the most appropriate investigation?

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Correct answer: E — Liver ultrasound every 6 months with or without alpha-fetoprotein depending local practice

Cirrhosis remains a risk factor for hepatocellular carcinoma even after hepatitis C cure. Surveillance is typically ultrasound every 6 months, with AFP use varying by guideline and local practice.

Reference: Canadian Association for the Study of the Liver HCC guidance