Table 1.
Differences regarding surveillance among the major guidelines.
| AASLD [104,106] | EASL [94,103] | APASL [102] | |||
|---|---|---|---|---|---|
| Modality | AFP | Yes * | No | Yes—biannually (in combination with US) | |
| US | Liver Cirrhosis | Yes—every 6 months | Yes—every 6 months | Yes—every 6 months | |
| Hepatitis | Yes—every 6 months in high-risk patients | Yes—every 6 months in high risk patients § | Yes—in high-risk patients (timing not specified) | ||
| High-risk patients | Cirrhotic patients | Cirrhosis HBsAg-positive and also with HBsAg seroclearance | Child–Pugh stage A and B Child–Pugh stage C awaiting liver transplantation |
HBV-related | |
| Non-cirrhotic patients |
With HBsAg seroclearance: a first degree family member with HCC, or a long duration of infection (>40 years for males and >50 years for females who have been infected with HBV from a young age) HBsAg-positive adults: -Asian or black men > 40 years -Asian women > 50 years -Persons with a first-degree family member with a history of HCC -Persons with HDV |
-HBsAg-positive patients: according to PAGE-B classes for Caucasian subjects, respectively 10–17 and ≥18 score points -F3 patients, regardless of etiology may be considered for surveillance based on an individual risk assessment |
Chronic HBV carriers: -Asian female > 50 years, -Asian males > 40 years, -Africans aged > 20 years, -History of HCC in the family |
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* Optional, but always in combination with US. § Patients at low HCC risk left untreated for HBV and without regular six months of surveillance must be reassessed at least yearly to verify progression of HCC risk. APASL = Asian Pacific Association for the Study of the Liver; AASLD = American Association for the Study of Liver Diseases; EASL = European Association for the Study of the Liver; HCC = hepatocellular carcinoma; AFP = alpha-fetoprotein; US = ultrasonography; HBV = hepatitis B virus; HDV = hepatitis D virus.