Hepatocellular carcinoma ultrasound surveillance adherence and outcomes in the UK: a multicentre retrospective service evaluation

Authors: Wigmore, E., Abimanue, N., Parry, T., Aslam, A., Cowen, J., Gangi-Burton, A., Aravinthan, A.D., Franklin, J., Tsao, A., Burnett, A., Fielding, B.F.S., Khine, C.K., Gadhia, C., Seiersen, D., Ng, E., Adams, H., Komber, H., Amin, I., Perkins, J., Williams, L., Qurashi, M., Dziadulewicz, N., Spears, O., Loganathan, P.D., Armstrong, R., McKinnon, S., Manuel, S., Mon, S.Y., Nesko, T., Aye, M.T.

Journal: Frontline Gastroenterology

Publication Date: 01/01/2026

eISSN: 2041-4145

ISSN: 2041-4137

DOI: 10.1136/flgastro-2026-103777

Abstract:

Objective: Hepatocellular carcinoma (HCC) is the most common primary liver cancer and fastest rising cause of cancer-related mortality within the UK, predominantly due to advanced stage at presentation. Ultrasound surveillance (US) is recommended every 6 months in select high-risk patients to enable earlier detection of HCC. This study assessed adherence rates, surveillance episode outcomes and associated influencing factors. Methods: A multicentre retrospective service evaluation across 18 UK centres of patients enrolled in HCC surveillance from 1 January 2022 to 31 December 2022 was performed. Data collected included patient demographics, liver disease aetiology and comorbidities. Number of completed HCC surveillance ultrasound examination requests, attendance and outcomes as defined by US-LIRADS v2017 were recorded. Provider adherence was defined by examination request completion and patient compliance by examination attendance. Provider adherence and patient compliance were presented as descriptive statistics, and risk differences were calculated for influencing factors. Results: Study cohort consisted of 1713 patients, with 2285 surveillance ultrasound examinations requested, and 88% (2018/2285) attended. Only 38% (659/1713) of patients attended two ultrasound examinations during the 12-month adherence period. Provider full adherence was 49% (839/1713), partial adherence 35% (607/1713) and non-adherence 16% (267/1713). Patient full compliance was 83% (1199/1446), partial compliance 11% (160/1446) and non-compliant 6% (87/1446). Most examinations were categorised as US-1 Negative (95%, 1927/2018), followed by US-3 Positive (2%, 45/2018) and US-2 Subthreshold (2%, 42/2018). Conclusion: HCC US delivery across the UK is suboptimal, highlighting the need for urgent investment in surveillance programmes, focusing on development of robust tracking and patient recall mechanisms.

Source: Scopus