New National Standards for Liver Cancer Surveillance Revealed at UK Conference
Friday 10 October, 2025 – A new article published in Frontline Gastroenterology and presented at the leading liver conference in the UK has revealed a concerning gap in care for liver cancer patients. The article, titled “Hepatocellular Carcinoma Surveillance: Minimum Standards,” highlights the low attendance rate for regular monitoring among eligible patients and the potential consequences for early detection and survival.
Experts estimate that only one in five eligible patients are consistently participating in surveillance programs, despite clear recommendations for regular monitoring. This is particularly alarming considering that most people who develop hepatocellular carcinoma (HCC), the most common type of primary liver cancer, already have liver disease. Up to 90% of cases involve cirrhosis, which can be caused by viral hepatitis, alcohol-related liver disease, or metabolic dysfunction-associated steatotic liver disease (MASLD) linked to rising obesity rates in the UK.
Early detection is crucial in improving treatment outcomes for liver cancer. When caught early, curative treatments such as surgery or ablation are often possible. However, the low attendance rate for surveillance means that many patients are still being diagnosed at a later stage when treatment options are limited and outcomes are poorer.
Lead author of the guidance and consultant Hepatologist at Newcastle Hospitals, Professor Stuart McPherson, emphasizes the importance of surveillance in saving lives. “Effective surveillance saves lives,” he says. “But too many patients are missing out. These minimum standards are designed to make sure that everyone at risk is identified, followed up, and supported to stay in the system.”
The guidance also highlights several reasons why patients may not attend regular surveillance, including fear of a diagnosis, stigma, and difficulties understanding medical letters. Practical issues such as challenges in accessing scans, the absence of recall systems, and the lack of a national liver cancer registry also contribute to the low attendance rate.
Vanessa Hebditch, Director of Policy at Liver Cancer UK, part of the British Liver Trust, expresses concern over the current state of liver cancer surveillance in the UK. “Liver cancer is the fastest rising cause of cancer death in the UK,” she says. “Finding people with an early stage of liver cancer is vital to ensure that they receive treatment as soon as possible.”
To address the barriers preventing patients from attending regular surveillance, the new standards call for reliable systems to identify and recall at-risk patients, clear communication using plain language, timely access to follow-up scans, and stronger coordination between NHS liver services.
The guidance is currently being discussed at the British Association for the Study of the Liver conference taking place in Belfast between 8th and 10th October. “This is a call to action for liver services across the UK,” concludes Professor McPherson. “Surveillance only works if people take part, and that means making it easier and more supportive for patients.”
The full guidance is available online in Frontline Gastroenterology: https://fg.bmj.com/content/16/e1/e34
