Table 2.

Principles of Disease Surveillance and Its Applicability to Surveillance of CCA in Patients With PSC

Criteria for a Successful Surveillance Strategy	Met or Not
Defined population at risk	Yes • Patients with PSC
Available, affordable, acceptable surveillance modalities	Yes • Annual MRI/MRC with CA 19‐9
Available, affordable, acceptable treatment modalities	Yes, but very limited • Resection for early disease with well‐compensated liver function • Neoadjuvant chemoirradiation followed by liver transplantation for early perihilar CCA in highly specialized centers
Cost‐effectiveness of the process	Unknown • Because the annual incidence rate of CCA in PSC is 1.5%, which is comparable with incidence of hepatocellular carcinoma, surveillance might be justified
Standardization of the process	None
Patient survival benefits	Yes • Benefits are limited to patients with resectable and early perihilar disease treated with neoadjuvant chemoirradiation followed by liver transplantation in highly specialized centers