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Individuals with cirrhosis are at greatly increased risk of death from both liver failure and hepatocellular carcinoma (HCC). In this context, many specialist societies recommend using ultrasound surveillance to detect HCC early with the aim to reduce mortality from liver disease and not only from HCC.1 ,2 This is a laudable aim but the studies defining the efficacy of surveillance are generally of low quality and there is no readily applicable randomised controlled trial of surveillance in a western population. Recent evidence syntheses are conflicting and while meta-analysis of non-randomised case–control studies suggests benefits of surveillance this cannot be applied to patients with cirrhosis in general.3 ,4
The study from Cross and coworkers in this issue of Frontline Gastroenterology used an online questionnaire …
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