Diagnosis at an advanced stage is common, when curative
treatments such as resection or transplantation are no longer viable12
This site is intended for US healthcare professionals.
Diagnosis
Overview
HCC is the most prevalent type of liver cancer, which is the thirteenth most common cancer in the United States (US) and a leading cause of cancer-related deaths worldwide.1,2 HCC is highly heterogeneous and frequently presents a dual challenge of managing the cancer itself and underlying liver dysfunction.3,4
In 2025 there were 42,240 new cases of liver cancer* and 30,090 deaths in the US.5
HCC will have a growing impact globally over the next several decades, with the number of new liver cancer cases projected to increase from 0.87 million in 2022 to 1.52 million by 2050.6
PRESENTATION AND ETIOLOGY
Early HCC
Liver-confined unresectable HCC
Advanced HCC
Clinical
presentation
Often few or no symptoms7
More prominent symptoms may include abdominal discomfort, fatigue, and loss of appetite7
Severe and disease-specific symptoms, which may include gastrointestinal symptoms related to liver dysfunction and cachexia7
Diagnosis
30% of patients are
diagnosed with very early
or early HCC†8
20% of patients are
diagnosed at this stage†8
50% of patients are diagnosed
with advanced HCC (including
10% at end stage)†8
5-year relative
survival rates,
2015–2021*9
Localized: 37.6%
Localized: 37.6%
Regional: 13.2%
Distant: 3.5%
*Liver and intrahepatic bile duct cancer.5,9†
In Western countries (Spain, Italy, United States, Latin America).8
The etiology of HCC in the US is shifting; while the main risk factors have traditionally been hepatitis B and C infection, non-viral causes such as metabolic dysfunction–associated fatty liver disease (MAFLD) and alcohol-related liver disease are becoming more frequent.1,10
UNMET NEED
Despite advances in understanding and treatment for HCC, significant unmet needs remain:11
Diagnosis at an advanced stage is common, when curative
treatments such as resection or transplantation are no longer viable12
Balancing preservation of liver function with reducing tumor burden through treatment can be challenging1,13
Disparities in healthcare access, including inconsistent availability
of multidisciplinary team (MDT) care, further complicate management11,14
Addressing these gaps is essential for improving outcomes and ensuring equitable care for all patients with HCC.11
SCREENING AND SURVEILLANCE
The American Association for the Study of Liver Diseases (AASLD) guidelines recommend surveillance in at-risk populations, including those with chronic hepatitis B infection or cirrhosis from any etiology.15
The guideline-recommended surveillance method is abdominal ultrasound combined with alpha-fetoprotein (AFP) testing; however, the sensitivity of this for detecting early HCC is only 63%,15 highlighting the need for advancements in surveillance techniques.
There are also implementation challenges in the US:
Low awareness of available screening guidelines and lack
of a comprehensive screening program 16
Low patient adherence to regular imaging, which can be influenced by factors such as scheduling and financial constraints, access to facilities, socioeconomic status, stigma, and patient perception of screening16
Lack of hepatologist involvement in high-risk patient care, leading
to surveillance gaps16,17
There is an urgent need to identify and validate reliable, non-invasive biomarkers for more effective screening, such as circulating tumor DNA (ctDNA), which has the potential to detect tumor-specific genetic and epigenetic alterations in the bloodstream.18
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