Table 1.

Professional society recommendations for HCC surveillance

Professional society	At-risk population	Surveillance tests	Frequency of surveillance	Notes
American Association for the Study of Liver Diseases (AASLD)	Patients with cirrhosis except Child-Pugh C unless awaiting liver transplantation	Ultrasound ± AFP	Every 6 months	CT or MRI are suggested if suboptimal liver visualization with ultrasound
National Comprehensive Cancer Network (NCCN)	Patients with cirrhosis	Ultrasound ± AFP	Every 6 months
US Department of Veterans Affairs	Patients with cirrhosis	Ultrasound + AFP	Every 6–12 months
American Gastroenterological Association (AGA)	Patients with cirrhosis	Ultrasound ± AFP	Every 6 months	Non-cirrhotic NAFLD patients with advanced (F3) fibrosis should be considered for HCC screening
European Association for the Study of the Liver (EASL)	Patients with cirrhosis, Child-Pugh A and B, or Child-Pugh C awaiting transplantation	Ultrasound	Every 6 months	HCC surveillance may be justified in patients with F3 fibrosis based on individual risk stratification
European Society of Medical Oncology (ESMO)	All cirrhotic patients as long as liver function and comorbidities allow curative or palliative treatments	Ultrasound ± AFP	Every 6 months
British Society of Gastroenterology (BSG)	Patients with cirrhosis, Child-Pugh A and B with controlled ascites, or Child-Pugh C awaiting transplantation	Ultrasound + AFP	Every 6 months
Asia-Pacific Association for the Study of the Liver (APASL)	Patients with cirrhosis	Ultrasound + AFP	Every 6 months
Japanese Society of Hepatology (JSH)	Patients with cirrhosis	Ultrasound + AFP + AFP-L3 + DCP	Every 6 months in high-risk patients; every 3–4 months in extremely highrisk patients

HCC, hepatocellular carcinoma; AFP, alpha fetoprotein; CT, computed tomography; MRI, magnetic resonance imaging; NAFLD, nonalcoholic fatty liver disease; AFP-L3, lens culinaris-agglutinin-reactive fraction of AFP; DCP, des-carboxy-prothrombin.