HCC Surveillance With Ultrasound, AFP Cost-Effective in Alcohol-Associated Cirrhosis

TUESDAY, Oct. 27, 2026 (HealthDay News) -- For patients with alcohol-associated cirrhosis, routine biannual hepatocellular carcinoma (HCC) surveillance with ultrasound and alpha-fetoprotein (AFP) is cost-effective when incidence exceeds 0.45 per 100 person-years, according to a study published online Oct. 15 in Clinical Gastroenterology and Hepatology.Ali Hajjar, Ph.D., from Harvard Medical School in Boston, and colleagues developed a microsimulation model to simulate the natural history of HCC and subsequent treatment pathways for patients with alcohol-associated cirrhosis. Biannual surveillance with ultrasound and AFP was compared to no surveillance for two cohorts: patients who continued to actively consume alcohol and patients who had achieved sustained abstinence.The researchers found that when annual HCC incidence reached approximately 0.45 per 100 person-years, biannual surveillance became cost-effective using a willingness-to-pay threshold of $100,000 per quality-adjusted life year (QALY). Surveillance yielded an incremental cost-effectiveness ratio (ICER) of $18,952 per QALY among active drinkers; the ICER was $56,000 per QALY among abstinent patients. Routine surveillance generated an estimated 2,083 additional life-years and 992 QALYs per 100,000 patients in active drinkers, and 3,357 life-years and 1,700 QALYs per 100,000 patients in those who had achieved sustained abstinence."We found that screening was cost-effective in both patients who kept drinking and those who had stopped," Hajjar said in a statement. "Catching cancer earlier gives these patients access to treatments that can extend their lives, so decisions about screening should not depend on drinking status alone."Abstract/Full Text (subscription or payment may be required)

HCC Surveillance With Ultrasound, AFP Cost-Effective in Alcohol-Associated Cirrhosis

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