AFP Screening in Patients with Hepatitis C
Positive predictive value for hepatocellular cancer was low; AFP screening is not recommended.
Recent guidelines recommend against serum α-fetoprotein (AFP) testing to screen for hepatocellular carcinoma (HCC) in patients with chronic hepatitis C (Hepatology 2011; 53:1020). Nevertheless, I still encounter cases in which clinicians have conducted AFP screening. In this study of 855 patients with histologically advanced chronic hepatitis C, researchers measured levels of AFP and two other biomarkers (AFP-L3 and des-γ-carboxy prothrombin [DCP]) every 3 months for 4 years. Patients also underwent yearly screening ultrasound imaging. HCC developed in 46 patients (5% of the cohort).