Optimizing hepatocellular cancer surveillance in metabolic associated fatty liver disease

Complications of chronic liver disease (CLD) are a major health burden in Western Australia being the 5th leading contributor of years of life lost in the state. One of the CLD complications, hepatocellular carcinoma (HCC) represents the third leading cause of death by cancer worldwide and the 7th leading cause in Australia. In Australia patients with HCC have a 5-year survival of less than 20% (3rd deadliest behind pancreas 9.9% and lung cancer 15%). Metabolic associated fatty liver disease (MAFLD) is the commonest cause of CLD and is projected to become the leading cause of HCC. Survival following a diagnosis of MAFLD-related HCC is dismal and less than 50% of patients are alive at 12 months. A major reason for this poor survival is inadequate screening for HCC in patients that have MAFLD. This results in a late diagnosis of HCC in these patients and no curative treatment options. The aim of this study is to develop a new blood test that will accurately identify those patients with MAFLD that are at high risk of developing HCC and to use this information to improve the identification of early-stage HCC that will allow a potential cure. To do this, we will perform a multicentre international study of patients with MAFLD.