The global incidence and mortality rates of hepatocellular carcinoma (HCC) are alarmingly high. Timely detection of HCC through surveillance is crucial for individuals with cirrhosis or other high-risk conditions to improve their overall survival. Although biannual ultrasonography with or without alpha-fetoprotein is currently the standard method for HCC surveillance, it has limited sensitivity in early-stage disease and may not be effective for some individuals.
This review article aims to comprehensively examine the current state of HCC surveillance, including the reasons and criteria for conducting HCC surveillance, conventional methods for HCC surveillance, and their advantages and disadvantages. Additionally, the review will discuss alternative surveillance methods such as cross-sectional imaging and emerging circulating biomarkers, as well as the issue of under-utilization of HCC surveillance and the potential harms associated with it.