Net Benefit of HCC screening

We have promoted the concept of net benefit for HCC screening, which involves balancing early detection with potential screening-related harms. We have characterized the clinical benefits of screening, including improved early tumor detection and associations with improved survival. Our group conducted the first studies to prospectively measure physical, financial, and psychological harms of screening.

Choi DT, Kum H, Park S, Ohsfeldt RL, Parikh ND, Singal AG. Hepatocellular Carcinoma Screening is Associated with Increased Survival of Patients with Cirrhosis. Clinical Gastroenterology Hepatology 2019; 17(5): 976-987.
Singal AG, Patihandia S, Obi J, Fullington H, Parikh N, Yopp AC, Marrero JA. Benefits and harms of hepatocellular carcinoma surveillance in a prospective cohort of patients with cirrhosis. Clinical Gastroenterology Hepatology 2021; 19(9): 1925-32.
Singal AG, Zhang E, Narasimman M, Rich NE, Waljee AK, Hoshida Y, Yang JD, Reig M, Cabibbo G, Nahon P, Parikh ND, Marrero JA. HCC Surveillance Improves Early Detection, Curative Treatment Receipt, and Survival in Patients with Cirrhosis: A Systematic Review and Meta-Analysis. J Hepatology 2022; 77(1): 128-139
Singal AG, Daher D, Narasimman M, Yekkaluri S, Liu Y, Cerda V, Banala C, Khan A, Lee M, Seif El Dahan K, Murphy C, Kramer J, Hernaez R. Benefits and harms of hepatocellular carcinoma screening outreach in patients with cirrhosis: a multi-center randomized clinical trial. JNCI 2025; 117(2): 262-269.
Daher D, Tadros M, Narasimman M, Yekkaluri S, Hernaez R, Singal AG. Incidental Findings During Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis. Clinical Gastroenterology and Hepatology 2025
Atiq O, Tiro J, Yopp AC, Muffler A, Marrero JA, Parikh ND, Murphy C, McCallister K, Singal AG. An Assessment of Benefits and Harms of Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis. Hepatology 2017; 65(4): 1196-1205.
Narasimman M, Hernaez R, Cerda V, Lee M, Sood A, Yekkaluri S, Khan A, Quirk L, Liu Y, Kramer J, Lee S, Murphy C, Tiro J, Singal AG. Hepatocellular carcinoma surveillance may be associated with potential psychological harms in patients with cirrhosis. Hepatology 2024; ;79(1): 107-117.
Narasimman M, Hernaez R, Cerda V, Lee M, Yekkaluri S, Khan A, Sood A, Gurley T, Quirk L, Liu Y, Kramer J, Lee S, Tiro J, Murphy C, Singal AG. Financial burden of hepatocellular carcinoma screening in patients with cirrhosis. Clinical Gastroenterology and Hepatology 2024; 22(4): 760-767.e1
Rich NE and Singal AG. Overdiagnosis of hepatocellular carcinoma: Prevented by guidelines? Hepatology 2022; 75(3): 740-53.
Singal AG, Yang JD, Jalal P, Salgia, Mehta N, Hoteit M, Kao K, Daher D, Seif El Dahan K, Hernandez P, Nayak A, Kim N, Pham S, Gamez J, Troost J, Parikh ND. Patient-perceived risk of HCC and net benefit of surveillance: A multi-center survey study. Am J Gastroenterology 2025