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Routine liver cancer screening is worth it for alcohol-related cirrhosis patients regardless of drinking status. A Harvard-led study found that biannual ultrasound and AFP testing becomes cost-effective when hepatocellular carcinoma (HCC) incidence exceeds 0.45 per 100 person-years. Researchers say screening decisions shouldn't hinge on whether a patient is still drinking.
Should doctors screen for liver cancer in patients who haven't stopped drinking? A new Harvard-led study says yes. Researchers used a microsimulation model to evaluate the cost-effectiveness of routine biannual hepatocellular carcinoma (HCC) surveillance — using ultrasound and alpha-fetoprotein (AFP) testing — in patients with alcohol-associated cirrhosis, comparing active drinkers to those in sustained abstinence.
The verdict: screening is cost-effective in both groups once HCC incidence crosses a key threshold. Earlier cancer detection opens the door to life-extending treatments, and the researchers argue that drinking status alone shouldn't determine who gets screened.
By the Numbers:
Why it matters: Patients with alcohol-associated cirrhosis are often deprioritized for cancer screening due to their drinking status. This study challenges that approach, showing that routine surveillance is both clinically beneficial and economically sound — potentially reshaping how clinicians approach HCC screening eligibility.
