Is Your HCC Practice Aligned with Global Standards?

Addressing the Global Divide in Liver Cancer Care

Hepatocellular carcinoma remains a major contributor to global cancer mortality. To address this challenge, the European Society of Gastrointestinal and Abdominal Radiology organized a global forum. However, a recent survey revealed stark intercontinental inequities in how we manage this disease. Effective HCC surveillance and treatment protocols vary widely depending on where a patient lives. For instance, multidisciplinary tumor boards are common in North America but remain scarce in under-resourced regions. Consequently, many patients miss out on optimal, timely interventions.

Current Realities of HCC Surveillance

In general, clinicians rely heavily on abdominal ultrasound and serum alpha-fetoprotein for routine screening. Although ultrasound is cost-effective, its diagnostic accuracy is highly operator-dependent. Furthermore, clinicians often struggle to access advanced tools like contrast-enhanced ultrasound or hepatobiliary-specific contrast agents in developing regions. In India, joint guidelines from national liver and imaging societies emphasize standardizing these imaging modalities. Specifically, the Indian National Association for Study of the Liver strives to align local screening practices with international benchmarks. However, achieving uniform clinical access to contrast-enhanced magnetic resonance imaging remains an uphill battle.

Impact on Multidisciplinary Care and Treatment

In addition to imaging gaps, multidisciplinary management varies significantly across continents. For example, tumor board meetings are vital for selecting the best therapy for complex liver tumors. As a result, only a fraction of centers in low-resource settings routinely conduct these joint clinical meetings. Therefore, treatment decisions may lack comprehensive specialist input. To close this gap, healthcare systems must invest in clinical education and local infrastructure. Consequently, training programs and standardized guidelines are essential to elevate the quality of liver cancer care globally.

Frequently Asked Questions

Q1: What primary tools do guidelines recommend for HCC surveillance?

A1: To begin, abdominal ultrasound combined with serum alpha-fetoprotein is the standard for routine screening. However, clinicians increasingly recommend advanced modalities such as contrast-enhanced ultrasound and magnetic resonance imaging when standard ultrasound is limited.

Q2: Why is a multidisciplinary tumor board important in managing hepatocellular carcinoma?

A2: In fact, multidisciplinary meetings bring together hepatologists, radiologists, and oncologists to determine the most effective treatment plan. Consequently, this collaborative approach significantly improves patient outcomes and survival rates.

References

1. Cannella R et al. Global disparities in hepatocellular carcinoma care: insights from the ESGAR Global Abdominal Imaging Forum. Eur Radiol. 2026 Jun 09. doi: 10.1007/s00330-026-12567-8. PMID: 42262399.
2. Joint Consensus Statement of the Indian National Association for Study of the Liver (INASL) and Indian Radiological and Imaging Association (IRIA) for the Diagnosis and Imaging of Hepatocellular Carcinoma (HCC) incorporating Liver Imaging Reporting and Data System (LIRADS).
3. Current and new strategies for hepatocellular carcinoma surveillance. PMC, June 2025.