{"id":6550,"date":"2025-07-31T13:32:26","date_gmt":"2025-07-31T04:02:26","guid":{"rendered":"https:\/\/hepatitissa.asn.au\/communitynews\/?p=6550"},"modified":"2025-08-18T11:58:51","modified_gmt":"2025-08-18T02:28:51","slug":"improving-surveillance-of-hepatocellular-carcinoma-in-australia","status":"publish","type":"post","link":"https:\/\/hepatitissa.asn.au\/communitynews\/2025\/07\/improving-surveillance-of-hepatocellular-carcinoma-in-australia\/","title":{"rendered":"Improving Surveillance of Hepatocellular Carcinoma in Australia"},"content":{"rendered":"\n<p class=\"has-drop-cap\">The incidence of primary liver cancer in Australia has quadrupled since 1982\u2014faster than any other cancer. Yet, the 5-year survival remains just 22%, in stark contrast to countries like Japan, where coordinated surveillance and early detection efforts have dramatically improved outcomes.<\/p>\n\n\n\n<p>A new <a href=\"https:\/\/www.mja.com.au\/journal\/2025\/223\/2\/opportunities-improve-surveillance-hepatocellular-carcinoma-australia\" target=\"_blank\" rel=\"noreferrer noopener\">peer-reviewed article<\/a> in the Medical Journal of Australia (co-authored by some of Australia\u2019s leading liver health experts) outlines five urgent actions needed to change this trajectory:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Support a nationwide campaign for liver disease health promotion, in partnership with community organisations<\/li>\n\n\n\n<li>Establish and fund a national approach to chronic liver disease screening and linkage to care, including timely access to liver fibrosis assessment<\/li>\n\n\n\n<li>Establish and fund a national HCC risk registry and surveillance program<\/li>\n\n\n\n<li>Fast-track approval and integration of blood-based biomarkers into HCC surveillance programs<\/li>\n\n\n\n<li>Set clear national targets for liver disease screening and assessment, HCC surveillance uptake, and HCC mortality.<\/li>\n<\/ul>\n\n\n\n<p><a href=\"https:\/\/www.aihw.gov.au\/reports\/cancer\/cancer-data-in-australia\/contents\/overview-of-cancer-in-australia-2023\" target=\"_blank\" rel=\"noreferrer noopener\"><\/a><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/hepatocellular-carcinoma\/cdc-20354552\" target=\"_blank\" rel=\"noreferrer noopener\">Hepatocellular carcinoma (HCC)<\/a> accounts for over 85% of primary liver cancers,<a href=\"https:\/\/www.mja.com.au\/journal\/2025\/223\/2\/opportunities-improve-surveillance-hepatocellular-carcinoma-australia#2\"> <\/a>and usually develops in the setting of chronic liver disease, with up to 90% of cases occurring in people with liver cirrhosis. It is usually caused by viral hepatitis, alcohol\u2010related liver disease or <a href=\"https:\/\/hepatitissa.asn.au\/communitynews\/2024\/12\/thinner-not-better-with-mafld\/\">metabolic dysfunction\u2010associated fatty liver disease (MAFLD)<\/a>. Importantly, when detected early, the cure rate for HCC is very high. In Australia, at-risk individuals should get 6-monthly liver ultrasounds, but this often does not happen.<\/p>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69d74d8eb8218&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69d74d8eb8218\" class=\"wp-block-image aligncenter size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"800\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/Hepatocellular_carcinoma_intermed_mag-1200x800.jpg\" alt=\"\" class=\"wp-image-6572\" srcset=\"https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/Hepatocellular_carcinoma_intermed_mag-1200x800.jpg 1200w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/Hepatocellular_carcinoma_intermed_mag-600x400.jpg 600w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/Hepatocellular_carcinoma_intermed_mag-300x200.jpg 300w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/Hepatocellular_carcinoma_intermed_mag-768x512.jpg 768w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/Hepatocellular_carcinoma_intermed_mag-rotated.jpg 1440w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Enlarge\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Micrograph image of hepatocellular carcinoma: <a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Hepatocellular_carcinoma_intermed_mag.jpg\">Image by Nephron<\/a>; used under CC license<\/figcaption><\/figure>\n\n\n\n<p>Due to a<a href=\"https:\/\/www.mja.com.au\/journal\/2021\/214\/10\/australian-recommendations-management-hepatocellular-carcinoma-consensus\" target=\"_blank\" rel=\"noreferrer noopener\"><\/a> low uptake of surveillance, most HCC cases are only detected at an advanced stage when only palliative treatments can be offered. <a href=\"https:\/\/repository.monashhealth.org\/monashhealthjspui\/handle\/1\/50993\" target=\"_blank\" rel=\"noreferrer noopener\">Data from Melbourne<\/a> show minimal change in the proportion of new HCC cases diagnosed through surveillance over the past decade, from 40% in 2013 to 39% in 2022.&nbsp;This is primarily due to lack of awareness among health workers and the community about who is actually at risk of chronic liver disease or HCC, the often asymptomatic nature of the early stages of chronic liver disease and HCC, a lack of awareness of the survival benefits of HCC surveillance for individuals at risk, and lack of access to HCC surveillance.<\/p>\n\n\n\n<p>As you might sadly expect, the impact of late diagnosis of HCC on mortality is even more striking among people who face barriers to care, including First Nations Australians and those who experience social and health disadvantages.<\/p>\n\n\n\n<p>But compare these alarming facts with those in some east Asian nations, where in the first two decades of this century both the incidence and mortality of primary liver cancer have <em>fallen<\/em>, reflecting successful preventive health initiatives that address viral hepatitis, such as hepatitis B vaccination and treatment, and hepatitis C cure. Importantly, however, it also reflects better early diagnosis and increased use of curative treatment.<\/p>\n\n\n\n<figure class=\"wp-block-pullquote\"><blockquote><p>In Australia, we have national surveillance programs for bowel, cervical and breast cancer, but we have no national population\u2010level screening programs for chronic liver disease and no national HCC surveillance program.<\/p><\/blockquote><\/figure>\n\n\n\n<p>The study focused on Japan as an example. In Japan, access to HCC surveillance and improvements in diagnostic methods and treatments have seen a dramatic improvement in 5\u2010year survival from 5% in 1980 up to 43% in 2005 and 58% in 2013.<\/p>\n\n\n\n<p>In Australia, implementation of advances in public health interventions for chronic liver disease, surveillance, diagnostic methods and treatments has followed a similar trajectory to Japan, but HCC survival has remained stubbornly low (currently sitting at 22%). What can Australia learn from countries such as Japan, who have seen such impressive reductions in HCC mortality?<\/p>\n\n\n\n<p>Since the 1980s, Japan has had a national HCC surveillance program, with annual education of GPs and health promotion campaigns for the general population about HCC and its risk factors being supported and financed by the Japanese Ministry of Health since 1999.&nbsp;Importantly, this program was embedded within pre\u2010existing national screening and treatment programs for viral hepatitis, facilitating early assessment for liver cirrhosis and linkage into HCC surveillance. In Australia, we have national surveillance programs for bowel, cervical and breast cancer, but we have no national population\u2010level screening programs for chronic liver disease and no national HCC surveillance program.<\/p>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69d74d8eb8930&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69d74d8eb8930\" class=\"wp-block-image aligncenter size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"1800\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/elen-sher-nbU4xF3YUbw-unsplash-1200x1800.jpg\" alt=\"\" class=\"wp-image-6575\" srcset=\"https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/elen-sher-nbU4xF3YUbw-unsplash-1200x1800.jpg 1200w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/elen-sher-nbU4xF3YUbw-unsplash-600x900.jpg 600w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/elen-sher-nbU4xF3YUbw-unsplash-300x450.jpg 300w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/elen-sher-nbU4xF3YUbw-unsplash-768x1152.jpg 768w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/elen-sher-nbU4xF3YUbw-unsplash-1024x1536.jpg 1024w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/elen-sher-nbU4xF3YUbw-unsplash-scaled.jpg 1365w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Enlarge\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Ultrasound scan: photo by Elen Sher on Unsplash<\/figcaption><\/figure>\n\n\n\n<p>Japan&#8217;s HCC program also includes delivery of surveillance via a national HCC risk registry and community\u2010based HCC surveillance centres and hospital settings at a minimal cost. Although as a geographically small and concentrated nation Japan has fewer geographical challenges to negotiate in delivery of its HCC program compared with Australia, centralised organisation of HCC surveillance with decentralised imaging delivery in clinics has proven effective to improve access to high quality HCC surveillance. In Australia, data from Victoria showed that during the early years of the COVID-19 pandemic, there was a shift from hospital-based to community\u2010based radiology services to deliver hepatology clinic\u2010led HCC surveillance programs. This resulted in no significant reduction in HCC detection rates, suggesting a similar model could work well nationwide.<\/p>\n\n\n\n<p>In Japan, those with viral hepatitis\u2010related cirrhosis are considered very high risk for HCC and have short\u2010interval surveillance every <em>three to four <\/em>months, combined with a dynamic computed tomography (CT) or magnetic resonance imaging (MRI) scan supported at a doctor&#8217;s discretion, which is significantly more frequent and thorough than the six-monthly ultrasounds recommended in Australia.<\/p>\n\n\n\n<p>Based on what has proven effective in Japan,&nbsp;the study makes the five recommendations listed above.<\/p>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;69d74d8eb8e4f&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"69d74d8eb8e4f\" class=\"wp-block-image size-full wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1091\" height=\"684\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/5keys.png\" alt=\"\" class=\"wp-image-6576\" srcset=\"https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/5keys.png 1091w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/5keys-600x376.png 600w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/5keys-300x188.png 300w, https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/5keys-768x481.png 768w\" sizes=\"auto, (max-width: 1091px) 100vw, 1091px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\taria-label=\"Enlarge\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.imageButtonRight\"\n\t\t\tdata-wp-style--top=\"state.imageButtonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><figcaption class=\"wp-element-caption\">Reproduced from the study paper under a CC license<\/figcaption><\/figure>\n\n\n\n<p>Despite Australia having ready access to advanced treatments for HCC in Australia, many lives are lost due to late detection. Increasing assessment for liver disease and cirrhosis in primary care, coupled with a strong, funded national HCC surveillance program using ultrasound and blood biomarkers, is vital if we want to reduce deaths from HCC.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The incidence of primary liver cancer in Australia has quadrupled since 1982\u2014faster than any other cancer. Yet, the 5-year survival remains just 22%, in stark contrast to countries like Japan, &hellip;<\/p>\n","protected":false},"author":3,"featured_media":6573,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_FSMCFIC_featured_image_caption":"","_FSMCFIC_featured_image_nocaption":"","_FSMCFIC_featured_image_hide":"","footnotes":""},"categories":[11,13],"tags":[32,34,43,317],"issue":[],"ppma_author":[57],"class_list":["post-6550","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-policies-research","category-living-with-hepatitis","tag-hepatitis-c","tag-hepatitis-b","tag-liver-cancer","tag-hcc"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Improving Surveillance of Hepatocellular Carcinoma in Australia | HepSA Community News<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/hepatitissa.asn.au\/communitynews\/2025\/07\/improving-surveillance-of-hepatocellular-carcinoma-in-australia\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Improving Surveillance of Hepatocellular Carcinoma in Australia | HepSA Community News\" \/>\n<meta property=\"og:description\" content=\"The incidence of primary liver cancer in Australia has quadrupled since 1982\u2014faster than any other cancer. Yet, the 5-year survival remains just 22%, in stark contrast to countries like Japan, &hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/hepatitissa.asn.au\/communitynews\/2025\/07\/improving-surveillance-of-hepatocellular-carcinoma-in-australia\/\" \/>\n<meta property=\"og:site_name\" content=\"HepSA Community News\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/HepatitisSA\" \/>\n<meta property=\"article:published_time\" content=\"2025-07-31T04:02:26+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-08-18T02:28:51+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/hepatitissa.asn.au\/communitynews\/wp-content\/uploads\/2025\/07\/Sydney-Tokyo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1106\" \/>\n\t<meta property=\"og:image:height\" content=\"720\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"James Morrison\" \/>\n<meta name=\"twitter:card\" 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