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24. Can regular screening lead to early detection?

Why is it important to undergo regular screening? Although not every person with chronic hepatitis B infection needs treatment, for those with elevated ALT appropriate anti-viral therapy can reduce the risk of liver cancer and cirrhosis and you are going to hear more about this later on by Dr. Mindy Newman. Regular screening for liver cancer can also lead to early detection just like mammograms that try and detect early breast cancer and hence the successful removal of the cancer and lower the risk of the cancer recurring after removal. At the moment, there is no effective systemic chemotherapy to treat unresectable liver cancer. So the best way to improve your chances of surviving liver cancer is early detection. This is a case of a 53 year old Asian gentleman who came to me for the first time for consultation and I asked him has anybody screened you for liver cancer? I mean this is a very wealthy person. And he said no. His doctors never screened him. So I did a screening. His AFP was negative but he had a very suspicious lesion in the liver and we did a triphasic CT scan which also showed the characteristics of liver cancer. The characteristics of liver cancer on the triphasic CT scan are if the anterior phase of the scan lights up and the venous phase actually gets less dense than the rest of the liver. So we took him to surgery and took out this little piece of liver and he had a 1.2 centimeter liver cancer in him. So if he waited, if no one screened him, he would have been dead. Now he is three years after his liver resection with no evidence of recurrence.