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HCC is highly fatal and often detected late, leaving UK 5-year survival below 20%. These evidence-based clinical practice guidelines address assessment and management, summarizing the clinical and scientific data behind recommendations and aligning treatment algorithms with UK-available, nationally approved therapies for the National Health Service.",{"@graph":69,"@context":114},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/british-society-of-gastroenterology-guidelines-for-the-management-of-hepatocellular-carcinoma-in-adults-guideline/337996/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/british-society-of-gastroenterology-guidelines-for-the-management-of-hepatocellular-carcinoma-in-adults-guideline/337996.png","ImageObject",300,407,{"name":92,"@type":93},"Liam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108],{"name":109,"@type":110,"acceptedAnswer":111},"What are the key radiological criteria for non-invasive diagnosis of HCC in cirrhotic patients?","Question",{"text":112,"@type":113},"Non-invasive radiological criteria apply only to cirrhotic patients and to nodules measuring 1 cm or more. 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To view, please visit the journal online ([https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.1136/gutjnl-2023-331695](10.1136/gutjnl-2023-331695)) .  \nFor numbered affiliations see end of article.  \nCorrespondence to  \nDr Abid Suddle, King’s College Hospital NHS Foundation Trust, London, SE5 9RS, UK; [abid.suddle@nhs.net](abid.suddle@nhs.net)  \nReceived 6 December 2023 Accepted 19 March 2024 Published Online First  \n16 April 2024  \n© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.  \nTo cite: Suddle A, Reeves H, Hubner R, et al. Gut 2024;73:1235–1268 .  \nAbsTrACT  \nDeaths from the majority of cancers are falling globally, but the incidence and mortality from hepatocellular carcinoma (HCC) is increasing in the United Kingdom and in other Western countries. HCC is a highly fatal cancer, often diagnosed late, with an incidence to mortality ratio that approaches 1. Despite there being a number of treatment options, including those associated with good medium to long-term survival, 5-year survival from HCC in the UK remains below 20% . Sex, ethnicity and deprivation are important demographics for the incidence of, and/or survival from, HCC. These clinical practice guidelines will provide evidence-based advice for the assessment and management of patients with HCC. The clinical and scientific data underpinning the recommendations we make are summarised in detail. Much of the content will have broad relevance, but the treatment algorithms are based on therapies that are available in the UK and have regulatory approval for use in the National Health Service.  \nExECuTivE summAry of rECommEndATions  \nPrevention of hepatocellular carcinoma  \n► National policies should be implemented to prevent transmission of viral hepatitis, reduce alcohol abuse and encourage lifestyle changes to minimise risks of obesity and metabolic syndrome (evidence high; recommendation strong).  \n► Vaccination against hepatitis B virus (HBV) should be carried out in all infants (as part of the childhood immunisation programme), people at high risk of exposure to the virus or complications of the disease (including those who inject drugs) and individuals already exposed to the virus (including infants born to HBV-positive mothers, people with needle stick injury) (evidence high; recommendation strong).  \n► Chronic liver diseases should be treated with the aim of preventing inflammation and progression of fibrosis (evidence high; recommendation strong).  \n► Patients with chronic hepatitis B infection should be treated with antiviral therapy to maintain suppression of viral replication (evidence high; recommendation strong).  \n► Patients with chronic hepatitis C infection should be treated with the aim of achieving viral eradication (evidence high, recommendation strong).  \n► In cirrhotic patients with chronic viral hepatitis, effective antiviral treatment reduces (but does not eliminate) the risk of hepatocellular carcinoma (HCC) and is recommended (evidence moderate; recommendation strong).  \n► Effective antiviral therapy should be maintained or instituted in patients with hepatitis Cand hepatitis B who undergo surgical or ablative treatments for HCC (evidence high; recommendation strong).  \n► Adjuvant therapy with atezolizumab and bevacizumab might improve recurrence-free survival after surgery or ablation, but longerterm follow-up is required before it can be recommended (evidence moderate; recommendation moderate).  \nSurveillance for hepatocellular car","cbCaivmqXeQhMsLL","https://ap.wps.com/l/cbCaivmqXeQhMsLL","pdf",1483045,34,"English","# Executive summary of recommendations\n## Prevention of hepatocellular carcinoma\n## Surveillance for hepatocellular carcinoma\n## Diagnosis of HCC\n### Radiological diagnosis of HCC","[{\"question\":\"What are the key radiological criteria for non-invasive diagnosis of HCC in cirrhotic patients?\",\"answer\":\"Non-invasive radiological criteria apply only to cirrhotic patients and to nodules measuring 1 cm or more. Initial assessment should use multiphase CT, multiphase MRI, or contrast-enhanced ultrasound, with CT or MR preferred. For lesions \\u003e1 cm, the typical hallmarks include late arterial phase hypervascularity combined with washout on portal venous and/or delayed phases, along with features such as threshold growth and capsule appearance depending on nodule size.\"}]","British Society of Gastroenterology guidelines for the management of hepatocellular carcinoma in adults - Guideline | PDF",1790021486,86]