ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 28
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Clinical practice guidelines for hepatocellular carcinoma
surveillance for people at high risk in Australia
Eleonora Feletto1, Dr Nicole Allard3, Prof Jacob George2
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The Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW,
Storr Liver Centre, The Westmead Institute for Medical Research Storr Liver Centre, Westmead
Hospital and University of Sydney, 3The Doherty Institute
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Primary liver cancer incidence and mortality are rapidly rising in Australia. Hepatocellular carcinoma
(HCC) is the most common type of primary liver cancer. HCC surveillance is a well-established
intervention to facilitate early detection through regular monitoring of populations at high risk. Evidence
has shown it to be successful in detecting lesions and/or early-stage tumours, increasing the receipt of
curative treatment and improving overall survival.
The clinical practice guidelines for HCC surveillance for people at high risk in Australia have
been developed in order to provide evidence-based information and recommendations to guide
surveillance for people at high risk of HCC. This presentation will provide an overview of the guideline
recommendations and their impact on practice.
Systematic literature reviews and cost-effectiveness modelling studies were completed, and the
evidence was appraised using the Grading of Recommendations, Assessment, Development and
Evaluations (GRADE) methodology. The guidelines were developed by a multidisciplinary working
group and overseen by an expert advisory group.
The guidelines build on existing international guidelines, national consensus statements and current
practice. They broadly align with current practice and consolidate guidance for the Australian context.
The recommendations reinforce the necessity for HCC surveillance in high-risk patients but also
highlight other aspects important for clinical practice:
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people for whom HCC surveillance should not routinely be offered are clearly identified
the importance of monitoring for progression to cirrhosis is highlighted
consideration of an individual’s risk and health status is recommended to inform HCC surveillance
recommendations for people with advanced fibrosis.
The recommendations are intended to guide decision making in determining who should receive
regular HCC surveillance and all should be considered for implementation in practice. This session will
demonstrate how HCC burden in patients with liver disease can be managed effectively by providing
routine surveillance.
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