Article Text

Download PDFPDF
Is it time for recommendations to reflect reality in PSC surveillance?
  1. James Hawken,
  2. Gautham Appanna,
  3. A J Portal
  1. Bristol Liver Unit, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  1. Correspondence to Dr James Hawken, Bristol Liver Unit, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 3NU, UK; jameshawken{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

We write in response to Nicoletti et al’s Guideline review: British Society of Gastroenterology/UK-PSC guidelines for the diagnosis and management of primary sclerosing cholangitis 1 in the January 2021 edition of Frontline Gastroenterology and the 2019 British Society of Gastroenterology (BSG) guideline it draws on.2

Guidelines often fall short of recommending surveillance for cholangiocarcinoma (CCA) in primary sclerosing cholangitis (PSC), but this seems at odds with what many hepatologists actually do due to fear of patients developing CCA and a diagnosis coming too late. It is likely that surveillance strategies vary at both regional and local level.

The risk of hepatobiliary cancer is …

View Full Text


  • Contributors JH wrote the initial draft. JH, GA and AJP edited the letter and agreed on the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.