HCC Updates: Quality Care Framework and Risk Stratification Data
Janice H. Jou, MD, MHS
Section Chief, Division of Gastroenterology
VA Portland Healthcare System
Portland, Oregon
Disclosures: Received research grant from: Gilead
Cynthia A. Moylan, MD, MHS
Associate Professor of Medicine
Director of Hepatology
Durham VA Medical Center;
Co-Director of GI-HEP Clinical Research Unit, Division of Gastroenterology
Duke University Medical Center
Durham, North Carolina
Disclosures: Received research grant from: GSK; Madrigal; Exact Sciences.
Received income in an amount equal to or greater than $250 from: Novo Nordisk; Sirtex; Boehringer Ingelheim.
The VA National Gastroenterology and Hepatology Program, the largest provider of cirrhosis care in the United States, recently examined factors related to hepatocellular carcinoma (HCC) diagnosis stage, treatment options, and patient survival in veterans in a retrospective study.1 The results emphasize the value of HCC screening and continuous patient engagement for improving diagnosis, treatment, and survival outcomes for veterans. They also demonstrate the practicality of creating a national quality improvement framework for HCC screening, diagnosis, and care.1
Veterans with cirrhosis due to chronic hepatitis C virus (HCV) remain at risk for HCC, even after achieving a sustained virological response (SVR). A 2024 retrospective cohort study of veterans with HCV-related cirrhosis concluded that liver stiffness measurement post-SVR could help stratify HCC risk.2 These data highlight the importance of ongoing HCC screening and active patient engagement to improve survival and, ultimately, quality of life for veterans living with this condition.
Factors Influencing HCC Diagnosis, Treatment, and Survival1
More than 2300 veterans were diagnosed with HCC in 2021. Of this group, 199 cases were evaluated in a random subsample to assess factors associated with HCC diagnosis stage, treatment, and survival.
1 
Factors Influencing HCC Diagnosis, Treatment, and Survival1
Factors Influencing HCC Diagnosis, Treatment, and Survival1
Veterans without consistent primary care (VA or non-VA) were often diagnosed with HCC later because of gaps in screening and monitoring. Treatment delays were largely attributed to scheduling challenges (particularly outside the VA), advanced-stage disease at diagnosis, challenges with transportation, and patient preference.1
Liver Stiffness, Chronic HCV Cirrhosis, and HCC Risk2
To better understand the role of liver stiffness measurement (LSM) (using vibration-controlled transient elastography) as a predictive tool for HCC risk, a retrospective study examined 1850 veterans with chronic HCV cirrhosis and sustained virological response (SVR) for a follow-up of nearly 5100 person-years.
Liver Stiffness, Chronic HCV Cirrhosis, and HCC Risk2
LSM is a valuable predictor of HCC risk in patients with HCV cirrhosis after SVR and can identify portal hypertension-related complications and guide surveillance decisions. Patients with LSM < 5 kPa and no diabetes may discontinue surveillance because of low HCC risk.2- Factors Influencing HCC Diagnosis, Treatment, and Survival1
More than 2300 veterans were diagnosed with HCC in 2021. Of this group, 199 cases were evaluated in a random subsample to assess factors associated with HCC diagnosis stage, treatment, and survival. 1 - Factors Influencing HCC Diagnosis, Treatment, and Survival1
- Factors Influencing HCC Diagnosis, Treatment, and Survival1
Veterans without consistent primary care (VA or non-VA) were often diagnosed with HCC later because of gaps in screening and monitoring. Treatment delays were largely attributed to scheduling challenges (particularly outside the VA), advanced-stage disease at diagnosis, challenges with transportation, and patient preference.1 - Liver Stiffness, Chronic HCV Cirrhosis, and HCC Risk2
To better understand the role of liver stiffness measurement (LSM) (using vibration-controlled transient elastography) as a predictive tool for HCC risk, a retrospective study examined 1850 veterans with chronic HCV cirrhosis and sustained virological response (SVR) for a follow-up of nearly 5100 person-years. - Liver Stiffness, Chronic HCV Cirrhosis, and HCC Risk2
LSM is a valuable predictor of HCC risk in patients with HCV cirrhosis after SVR and can identify portal hypertension-related complications and guide surveillance decisions. Patients with LSM < 5 kPa and no diabetes may discontinue surveillance because of low HCC risk.2 - Factors Influencing HCC Diagnosis, Treatment, and Survival1
More than 2300 veterans were diagnosed with HCC in 2021. Of this group, 199 cases were evaluated in a random subsample to assess factors associated with HCC diagnosis stage, treatment, and survival. 1 - Factors Influencing HCC Diagnosis, Treatment, and Survival1
- Factors Influencing HCC Diagnosis, Treatment, and Survival1
Veterans without consistent primary care (VA or non-VA) were often diagnosed with HCC later because of gaps in screening and monitoring. Treatment delays were largely attributed to scheduling challenges (particularly outside the VA), advanced-stage disease at diagnosis, challenges with transportation, and patient preference.1 - Liver Stiffness, Chronic HCV Cirrhosis, and HCC Risk2
To better understand the role of liver stiffness measurement (LSM) (using vibration-controlled transient elastography) as a predictive tool for HCC risk, a retrospective study examined 1850 veterans with chronic HCV cirrhosis and sustained virological response (SVR) for a follow-up of nearly 5100 person-years. - Liver Stiffness, Chronic HCV Cirrhosis, and HCC Risk2
LSM is a valuable predictor of HCC risk in patients with HCV cirrhosis after SVR and can identify portal hypertension-related complications and guide surveillance decisions. Patients with LSM < 5 kPa and no diabetes may discontinue surveillance because of low HCC risk.2
Click here to view more from Cancer Data Trends 2025.
,false