We hosted an inspiring HCC Oncology Dinner in Brisbane, gathering almost 40 healthcare professionals to explore advancements in Hepatocellular Carcinoma (HCC) surveillance.

Chaired by Prof. James O’Beirne from Sunshine Coast University Hospital, the event featured expert insights from Prof. Patricia Valery, @Dr. Jonathan Mitchell, and Dr. Manil Chouhan on the latest trends in HCC incidence, challenges in rural surveillance, and emerging tools like LI-RADS v2024 and biomarkers like GAAD for early, impactful detection.

The event fostered collaboration, innovation, and inspiring discussions on advancing HCC surveillance and improving patient outcomes.

In a recent interview Associate Prof Simone Strasser provided valuable insights on the greatest challenges in early detection of Hepatocellular Carcinoma (HCC) surveillance in Australia.

Associate Prof Strasser commented “We are going to have emerging tools for HCC surveillance and that means we have to put a lot of effort to identify the people in the community who are at the greatest risk of developing liver cancer so that surveillance can be applied to them.”

Roche Diagnostics Australia held an Independent Medical Education meeting exploring the approach to Hepatocellular Carcinoma (HCC) surveillance in Australia in Melbourne.

The event aimed to provide valuable insights into the latest advancements, challenges, and strategies surrounding HCC surveillance.

The meeting featured presentations from esteemed experts including A/Prof Simone Strasser, A/Prof Jessica Howell, Dr Manfred Spanger and Dr Ericka Flores and a panel discussion involving real-world case studies.

When asked on the key takeaways for the meeting A Prof Simone Strasser commented “…an understanding of the changing epidemiology of liver disease and liver cancer in Australia, and that we are going to have to enable the healthcare system and primary care to apply surveillance to
more and more people and that’s not going to be ultrasound based surveillance because we don’t have enough ultrasound practices and technicians in Australia to be able to apply to the whole community at risk and so we are going to need to have blood biomarkers that are applicable to that community.”

Dr Caran Cheung (GP working in Mascot, Sydney) discusses the implications of identifying and managing HCC surveillance patients in General Practice. Caran has a special interest in viral hepatitis and is a s100 HBV and HIV prescriber and clinical editor working with organisations to provide health education to GPs.

Your Resource Hub for Early Detection and Effective Management

Welcome to our website dedicated to addressing the pressing issue of primary liver cancer in Australia. As the country’s fastest-growing cause of cancer death, primary liver cancer often eludes detection until it’s too late for the latest treatments to make a significant impact.

Consequently, Australia lags behind with a 22% 5-year survival rate ¹, in stark contrast to Japan’s 58% ². With the looming threat of non-viral MASLD (metabolic-associated steatotic liver diseases) such as obesity, type 2 diabetes, and fatty liver (steatosis), action is imperative.

Recent estimates suggest that up to one-third of Australians may have fatty liver disease ³, placing obese patients at risk of developing chronic liver disease. The question arises: do you know how to identify and assist these patients, potentially averting chronic liver disease and liver cancer?

This platform is tailored for healthcare professionals (HCPs), including specialists, GPs, and nurses, who regularly interact with individuals at high risk of hepatocellular carcinoma (HCC), such as those with cirrhosis or hepatitis B virus (HBV).

Our content (reviewed by an HCC multi-disciplinary panel) aims to equip you with the knowledge, practical guidance, and resources necessary to identify at-risk individuals early, manage modifiable risk factors, and ultimately reduce the incidence of HCC while improving early diagnosis.

Join us in our commitment to combat primary liver cancer by staying informed, proactive, and prepared to make a difference in the lives of those at risk of this devastating disease.

Hepatocellular carcinoma surveillance and the emerging role of biomarker-based models

In the latest Research Review Educational Series, Associate Professor Simone Strasser, a senior staff specialist at Royal Prince Alfred Hospital, Sydney, explores hepatocellular carcinoma (HCC) surveillance and the emerging role of biomarker-based models.

Strasser notes that “it was presumed that with widespread uptake of neonatal and childhood hepatitis B vaccination, effective hepatitis B antiviral therapy, and high uptakes of hepatitis C curative therapies, rates of HCC would start to decline in the community”.

However, this has not happened, due to an increase in population rates of obesity-related metabolic-associated fatty liver disease (MAFLD). This places increasing emphasis on the prevention and management of obesity and metabolic dysfunction in our battle against HCC.

To learn more about the emerging challenges in this area you can read the full article here.

Alpha-fetoprotein (AFP) is a blood-based biomarker that’s used together with ultrasound to detect liver cancer, but it’s by no means a perfect test. Experts are hopeful that emerging, specific blood-based biomarkers will prove useful in liver cancer surveillance — potentially as stand-alone tests.

In these series of videos produced by the limbic, A/Prof. Simone Strasser and A/Prof. Jessica Howell discuss:

• how changes in the epidemiology of advanced liver disease – both in Australia and globally – present challenges to the surveillance and monitoring of hepatocellular carcinoma
• discuss ways that specialists can ensure at-risk patients are undergoing surveillance for HCC
• current and future approaches to HCC surveillance and monitoring

Watch the videos below:

The changing epidemiology of advanced liver disease and HCC

HCC surveillance in at-risk patients

Limitations of current HCC surveillance strategies and future solutions

Hepatocellular carcinoma (HCC) is largely preventable, with decades of time to intervene, yet millions still die from it. It is however not incomprehensible why this happens. The journey from liver disease to liver cancer is complex—a myriad of broken healthcare systems, patient behaviors, cultural influences, stigma, funding, and limited healthcare professional (HCP) capacity. At first glance, it seems overwhelming, leaving us with the question—where should we intervene?

Some cancers like breast cancer have high incidence but comparatively low mortality¹. Liver cancer is the opposite; it often goes undetected until it reaches a late stage, resulting in dismal prognosis. Late presentation is a top issue in liver cancer. Without pain receptors, the liver has minimal symptoms until it is damaged beyond cure. People usually die within 6 – 22 months of a late-stage HCC diagnosis.² HCC is known as the ‘silent killer’ and is typically diagnosed at a late stage, which has a <5% 5-year survival rate. If diagnosed early, the 5-year survival rate increases to 40 – 70%.^3&4

Given the complexity, there is no single solution. Rather, it will take concerted action from multiple stakeholders in the system to bring about positive change. That said, there are logical places to start. First, we need to understand the ecosystem. An ecosystem represents factors required to deliver a service, in this case, liver care. It helps identify solution, scope, and strategy by providing a holistic view of actors, processes, flow, influence, and relationships.

Hepatitis B and C are the major causes of chronic liver disease and liver cancer in the world. An ongoing infection causes inflammation in the liver. This extended inflammation can cause scarring, called cirrhosis, and can ultimately lead to liver cancer. The Asia-Pacific region bears the highest overall burden of HBV, with 59% of those living with chronic HBV, 26% of new infections, and 79% of deaths.⁵ Given the shifting etiology with rising fatty liver disease, there is a pressing need to re-assess risk factors and stratify patients to ensure we are not failing to detect. Being able to optimize surveillance protocols based on patient risk will improve efficiency and ability to catch early HCC and drastically improve survival.

To further maximize the benefit of a surveillance program, or any other initiative, it is important to consider surrounding opportunities up- and down-stream. For example, surveillance programs will benefit from upstream awareness efforts to improve throughput, and down-stream availability of treatments. This paper provides an appreciation for the end-to-end patient journey and their needs along the way. Fundamentally, it advocates for the improvement of human life in the midst of receiving liver care, both clinically and experientially.

From the research, a central theme emerged – ultrasound used in HCC surveillance is a major bottleneck. It is the cause of delayed or even missed diagnosis, and stark inequities in care. Biomarkers such as PIVKA-II complementing AFP show promise in lessening this problem while also offering improved sensitivity and specificity for HCC detection.

This White Paper intends to facilitate concerted action among HCPs, patient advocacy groups, payers, and policy makers to reduce liver cancer incidence and mortality in APAC. It shares both holistic ecosystem and detailed human-centric insights as a starting point for change. Working with Key Opinion Leaders (KOLs) we provide tangible examples of active initiatives, and recommendations for taking the next steps.

Download or read the white paper below to find out more.

Stay tuned for interviews with select KOLs featured in the white paper, as they share about their insights and learning points on the initiatives piloted in their country.