Updated: 19 January 2006

Predisposing Factors/ Prevention

Patients with chronic hepatitis B or C infection or hemochromatosis are at increased risk for liver cancer. Those with alcoholic cirrhosis are also at increased risk. Primary prevention with vaccination for hepatitis B vaccine has resulted in decrease in hepatitis related liver cancer in endemic regions or countries. In 1992 the WHO recommended universal hepatitis B vaccination in all countries, including countries like Canada with low endemicity. There is as yet no vaccine for hepatitis C although judicious use of blood products, effective blood product screening for viral hepatitis, and IV drug control programs will minimize risk for hepatitis C infection. Work exposures to solvents are also a known risk factor for hepatocellular carcinoma as is environmental factors such as aflatoxin.

Screening/ Early Detection

Screening of patients without risk factors is not recommended. Individuals with chronic viral hepatitis may benefit from screening with periodic ultrasound and/or alpha-fetoprotein for early detection, although this has not been shown in a randomized trial to improve survival to date. The frequency of periodic screening is variable in clinical practice; however, the American Gastroenterology Society recommends a 6 monthly interval.