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Liver Cancer Screening

Liver cancer screenings are medical tests and evaluations that determine if cancer is present, even if you don’t have symptoms. Although there is not a standard liver cancer screening plan for everyone, most health insurance plans will cover liver cancer screening if your medical history indicates that you’re at an elevated risk. 

If you have an elevated risk of developing liver cancer, there may be screening tests available to help identify it at an early stage, when it’s most treatable. 

Identifying Your Risk Factors for Developing Liver Cancer

The following conditions, or a combination of conditions, can put you at a higher risk for liver cancer. Talk to your primary care provider about whether you should start a liver screening program if you have any of the following:

  • Cirrhosis - Cirrhosis is a condition that affects the liver and is often caused by damage to the tissues of the liver. The damaged tissues are replaced by scar tissue which reduces the ability of the liver to function correctly. The most frequent cause of cirrhosis is alcoholism or alcohol abuse. However, cirrhosis can also be caused by liver disease, hepatitis (B and C), or iron levels that are too high (hemochromatosis).
  • Obesity - General obesity can cause the liver to be covered in additional fat deposits. These deposits can lead to non-alcoholic fatty liver disease. Obesity is also closely linked with diabetes. Recent research strongly suggests that these two conditions are closely related to increases in the risk of liver cancer.
  • Hepatitis - Viral hepatitis is a disease that directly affects the liver. Globally, hepatitis is the leading risk factor for developing liver cancer.

The following factors can increase liver cancer risk, especially when paired with one of the conditions listed above. 

  • Being male - While liver cancer can develop in men and women, men are at a higher risk of developing liver cancer.
  • Being over 60 - Once people reach 60 years of age, they are at increased risk of developing liver cancer.
  • Environmental impact - Several lifestyle choices or environmental exposures can lead to an increased risk of developing liver cancer. In general, following a healthy diet, avoiding smoking, excess alcohol consumption, and maintaining routine physical activity can help reduce your risk of developing liver cancer.

The risks associated with each of these factors are a cumulative issue. That means that the more of these factors an individual has, the more likely they will develop liver cancer. 

Identifying Your Liver Cancer Screening Plan

If you have one or more of these conditions, it’s important to talk to your doctor about liver cancer screening. Together, you can develop a plan to see if you need to be screened regularly for liver cancer. 

When you enter into a screening plan for liver cancer, there are several different methods that your doctor can use, and in some cases they may use more than one. The most common are:

  • Physical Exam - A physical exam will include a general physical to see how your health is doing in general. Your doctor will palpate or feel your abdomen for lumps, swelling, or other changes in the liver or nearby organs.
  • Blood Test -  There is a blood test that can be used to detect higher levels of AFP, a substance that is found in 50-70% of people who have a common type of liver cancer called hepatocellular carcinoma. This is the most common type of liver cancer in the United States. When elevated AFP levels are found, it warrants a look further to determine if there is cancer present, or perhaps another condition such as hepatitis B or C. 

If further testing is needed after the initial exam and blood test, the doctor may order one or more of the following: 

  • Ultrasound - An ultrasound produces an image based on bouncing waves on structures in your body. The ultrasound can look at the organs and potentially identify any tumors or masses on the liver. 
  • CT Scan - This approach creates a higher quality 3-D image that doctors can use to look closely at the liver and other organs to see if any abnormalities require further investigation. 
  • Exploratory Laparoscopic Surgery - A laparoscopic procedure uses small incisions and specialized equipment to look inside the body. This can be a direct look at potentially cancerous tissues. During a laparoscopic evaluation, surgeons generally collect tissue samples for further analysis. 
  • Biopsy - A biopsy evaluates the tissue collected from the suspected cancerous area to determine cancerous cells are present. 

Understanding the Goals of Liver Cancer Screening

Liver cancer screenings are set at periodic intervals throughout an individual’s life. You may be screened more or less frequently based on the presence or absence of specific risk factors. In individuals that have higher levels of risk for liver cancer, they’ll likely be screened more often. 

Cancer screenings have two main objectives. 

  1. To lower the number of individuals who die from liver cancer. 
  2. To reduce the number of people who develop liver cancer.

The screenings help to achieve these goals by detecting cancer as soon as possible. Early detection is one of the most significant factors in the successful treatment of cancer. This approach helps to find cancer when it is smaller, before it has spread, and potentially before it causes significant adverse effects to the body. 

Early detection gives your cancer treatment a broader range of treatment options. When oncologists can treat cancer with less invasive options, at an earlier stage, patients have a shorter recovery time with a higher chance of complete removal of the cancer cells. 

How to Start Liver Cancer Screening

If you believe that you may be at a higher risk of liver cancer, talk to your primary care doctor about receiving liver cancer screening.

Compass Oncology - The US Oncology Network