Amit Singal, MD, MS

The incidence of HCC has increased over the last 10 years, with more than 1 million cases projected by 2025.^1,2 Although mortality rates—which have risen over the past decade—appear to be leveling out, improved surveillance and screening efforts are still critical for decreasing mortality.³ More intensive, multifaceted interventions—such as increasing patient and provider education, which are currently underutilized in clinical care—are needed, as well as the start of earlier screening for HCC.⁴ The use of new imaging and biomarker, GALAD, and liquid biopsy techniques is also being explored, although these techniques still require validation prior to routine use in clinical practice.^5-7 The  current ultrasound screening methods alone are not ideal, with sensitivity as low as 47% for detecting  early-stage HCC.⁸

Generally, multidisciplinary care has also been emphasized in the treatment process, using oncologists, radiologists, hepatologists, and surgeons working together to improve clinical outcomes.⁹ Recent treatment advances have been reported for early-, intermediate-, and late-stage disease. For early-stage HCC, surgical resection and transplant criteria have been expanded through downstaging techniques.¹⁰ For intermediate-stage HCC, radioembolization has been incorporated as another therapy, beyond transarterial chemoembolization.^11,12 For late-stage HCC, treatment is moving toward immunotherapy, which has generated longer survival than older therapies.¹³ While HCC remains a cancer of concern, new interventions, tools, and treatments on the horizon can help expand screening and improve treatment outcomes.