The Malaysian Society of Gastroenterology and Hepatology Consensus Statements on Prevention and Early Detection of Hepatocellular Carcinoma in Malaysia.
Lau SY, Kok VS, Tan SS, Adnan SD, Ng WL, Ang BH, Yaacob NY, Lee YY, Kaur S, Mohamed R, Wong PF, Lim LL, Letchumanan M, Vethakkan SR, Noor NM, Tan SF, Low TL, Kiew LB, Chan WK
Background
Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer-related deaths in Malaysia. Early detection increases the likelihood of curative treatment and improves survival. This consensus document aims to provide evidence-based, locally relevant recommendations for the prevention and early detection of HCC.
Methods
Nineteen experts from gastroenterology and hepatology, radiology, endocrinology, and family medicine were convened by the Malaysian Society of Gastroenterology and Hepatology. A modified Delphi method was used to prepare the consensus statements.
Results
Twenty-two out of 26 statements achieved consensus and are included in this document. These statements addressed HCC prevention, risk stratification, surveillance strategies, barriers to effective surveillance, and recommendations on linkage to specialized hepatology care. Preventive measures include universal Hepatitis B vaccination for newborns, treatment of Hepatitis B and C, and lifestyle modification. Six-monthly surveillance with ultrasound and serum alpha-fetoprotein (AFP) is the current standard of care; however, adjunctive novel biomarkers and imaging can improve early HCC detection. Early identification of at-risk patients using noninvasive fibrosis assessment in the primary healthcare and endocrinology setting are equally important.
Conclusion
Active surveillance of at-risk patients is crucial in improving early HCC detection and patient survival. The efficacy of HCC surveillance requires greater awareness, better identification of at-risk patients and clear referral pathways, supported by multidisciplinary collaboration. This consensus document provides a practical, evidence-based approach to optimizing HCC prevention and early detection, with the goal of improving patient outcomes.