The leading causes of chronic liver disease associated with HCC are hepatitis B and C viruses throughout the world, and alcohol and NASH in France. After increasing for 20-30 years in France, the rise in the incidence of HCC appears to be slowing and the death rates appear to be falling. Screening for HCC by liver ultrasound is performed every 6 months. Assay of serum alpha-fetoprotein has no benefit. In developed countries, failure to identify patients with cirrhosis and inadequate adherence to guidelines greatly reduces the effectiveness of screening for HCC.
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