Table 1: Strategies to improve hepatocellular carcinoma (HCC) policy
Strategy
Description
Access to
All those at risk of and/or diagnosed with liver cancer have access to recommended medical
treatments
care, including the ability of doctors to request screening and tests for liver function and
asymptomatic disease through liver cancer prevention, treatment and management, paid by
governmental and/or private health insurance.
Centers of
Referral of patients with liver cancer and also those with viral hepatitis or other liver diseases
excellence
that increase risk of liver cancer, to medical centers or institutions with major liver disease
departments diagnosing, treating and conducting the latest research in liver cancer.
Clinical education
Education of primary healthcare providers (general practitioners, internists, gastroenterologists,
hepatologists, et al) about liver cancer, including the importance of early risk assessment and
management of hepatic diseases to prevent progression to liver cancer.
Measuring social
Measuring the health care cost of liver cancer including the cost or burden of disease to
burden
society, compared to screening, earlier detection and management of those at risk of or with
liver cancer.
Monitoring of at-
Monitoring at-risk populations to detect liver disease and early tumors, including the
risk populations
stratification of disease risk and hepatic disease surveillance in those at greatest risk of
developing HCC.
Multidisciplinary
Because of the complex nature of liver cancer and multiple contributing factors, a highly skilled
management
multidisciplinary team approach is required for management of liver cancer, surgically and nonsurgically, as well as management of patients with hepatitis and other diseases that
significantly increase the risk of developing liver cancer.
National
The establishment and maintenance of national, evidence-based standards and guidelines for
guidelines
the adoption of prevention and treatment of liver disease and surveillance and treatments of
liver cancer.
Public awareness
Widespread awareness of risk factors for liver disease at large and for liver cancer in the
general population, including organized consumer liver disease and liver cancer advocacy.
Research
Increased infrastructure, including capacity and qualified personnel, to conduct translational,
infrastructure
clinical and basic research in all stages of liver cancer, from prevention through to end-stage
disease.
Risk-assessment
Earlier and improved risk assessment and screening by primary healthcare providers (general
and referral
practitioners, internists, gastroenterologists, et al) and immediate referral of patients with
confirmed liver disease and/or liver cancer to medical experts in those specific hepatic diseases
and in HCC.
Transplantation
Improved transplantation infrastructure and allocation of livers, including total liver transplants
infrastructure
as well as partial transplants from living donors; includes highly skilled surgical and other
medical personnel, latest transplant techniques and technology.