I spoke with my specialist, and they mentioned that I will need to get my liver enzymes, viral load, as well as core and surface antigens tested every 3 months. I inquired about annual liver imaging and was told that it’s not necessary until the age of 50, unless I have a direct family member with HCC. My parents do not have HCC, but even if they do, it’s likely that I’d find out a little too late because my dad refuses to go see the doctor. Unfortunately, my grandma – his mom, was recently diagnosed with stage 4 HCC in her early 70s. Even after informing my specialist that my grandma has been diagnosed with HCC, she insists that it wouldn’t be necessary.
What are your thoughts on this? Is it possible for my liver enzymes to come back normal but still develop HCC?
Hi @optimisticmama ,
That is strange. I get an ultrasound done every 6 months for some years now. Where are you located? Unless this is due to insurance, but I am not aware of any guidelines stating so. HBV patients either get an abdominal ultrasound every 6 months or annually.
Dear @optimisticmama, great question and the truth is this is different across the world and is also different depending on where you are from (as risk of HCC is different among people with different backgrounds). For example, people from sub-Saharan Africa may have higher risks of HCC when younger (we don’t know exactly why, but some factors include exposure to aflatoxin through peanuts), which would justify screening younger patients with ultrasound. Indeed this is reflected in the Australian guidelines around HCC screening, where the age of when people are starting to be screened differ depending on ethnicity (MAGICapp - Making GRADE the Irresistible Choice - Guidelines and Evidence summaries).
It also will depend on whether you have underlying cirrhosis or not. If you have cirrhosis, then there is a higher chance of you getting HCC (compared to if you don’t have cirrhosis). This will also be factored into the decision as to whether to screen.
Different countries also have different practices - when I was in Germany, I had a fibroscan and ultrasound every 6 months whereas this is not the norm in Australia.