Table 5.

Groups for whom HCC surveillance is recommended or in whom the risk of HCC is increased, but in whom efficacy of surveillance has not been demonstrated.

Population group	Annual incidence (percentage per year) for which surveillance is considered to be cost-effective	Incidence of HCC
Surveillance recommended
Asian male hepatitis B carriers over age of 40 years	0.2	0.4%–0.6% per year
Asian female hepatitis B carriers over age of 50 years	0.2	0.3%–0.6% per year
Hepatitis B carrier with family history of HCC	0.2	Incidence higher than without family history
African/North American blacks with hepatitis B	0.2	HCC occurs at a younger age
Cirrhotic hepatitis B carriers	0.2–1.5	3%–8% per year
Hepatitis C cirrhosis	1.5	3%–5% per year
Stage 4 primary biliary cholangitis	1.5	3%–5% per year
Genetic hemochromatosis and cirrhosis	1.5	Unknown, but probably >1.5% per year
Alpha-1 antitrypsin deficiency and cirrhosis	1.5	Unknown, but probably >1.5% per year
Other cirrhosis	1.5	Unknown
Surveillance benefit uncertain
Hepatitis B carriers younger than 40 (males) or 50 (females) years	0.2	<0.2% per year
Hepatitis C and stage 3 fibrosis	1.5	<1.5% per year
Non-cirrhotic NAFLD	1.5	<1.5% per year

Source: Adapted from Bruix and Sherman.⁸⁴ Copyright©2010 John Wiley & Sons. Graphic 68371 Version 8.

HCC: hepatocellular carcinoma; NAFLD: non-alcoholic fatty liver disease.