Screening for hepatocellular carcinoma in high-risk individuals. A clinical review.

Hepatocellular carcinoma occurs primarily in individuals with chronic hepatitis B infection and cirrhosis. This tumor is curable only when diagnosed at an early stage and then surgically resected. Therefore, screening tests have been used to identify small tumors in high-risk patients. Currently, the most sensitive and specific tests available involve measurement of serum alpha-fetoprotein levels and high-resolution ultrasonography. The results of these tests are often complementary in making a diagnosis. To be most cost-effective, the frequency of screening can be adjusted to the degree of risk of hepatocellular carcinoma.