Detection of early-stage hepatocellular carcinoma: a retrospective evaluation of ultrasonography surveillance and surveillance adherence.

Background: Hepatocellular carcinoma (HCC) surveillance using 6-monthly ultrasonography (US) intervals is recommended. This study investigated the factors associated with early-stage HCC detection. Methods: All patients with a new HCC diagnosis for the first time between 2019 and 2022 were included. All pre-treatment imaging was independently reviewed according to Liver Imaging Reporting and Data System (LI-RADS) criteria. Early-stage HCC was defined as a single tumour <50 mm or up to 3 tumours all <30 mm. Rate of adherence was expressed as the proportion of the number of 6-monthly surveillance US performed relative to the total number of surveillance US the patient should have undergone over the preceding 5 years or since the diagnosis of cirrhosis, if it was within the preceding 5 years. Results: The study cohort included 175 patients with new HCC. The median age at diagnosis was 71 years; 78% were males; median body mass index (BMI) was 29.3 kg/m Conclusions: Being part of primary surveillance, irrespective of adherence rate, is associated with early stage HCC detection. As many patients as possible should be enrolled into primary surveillance programme, even if adherence to recommended frequency is not followed rigorously.