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Summary of Evidence

Note: Separate PDQ summaries on Adult Primary Liver Cancer Treatment and Childhood Liver Cancer Treatment are also available.

Benefits

Based on fair evidence, screening of persons at elevated risk does not result in a decrease in mortality from hepatocellular cancer.

Magnitude of Effect: No reduction in mortality.

Study Design: Randomized controlled trials.

Internal Validity: Fair.

Consistency: Multiple studies, large number of participants.

External Validity: Fair.

Harms

Based on fair evidence, screening would result in rare but serious side effects associated with needle aspiration cytology such as needle-track seeding, particularly of lesions more than 2 cm in diameter, and hemorrhage, bile peritonitis, and pneumothorax. Transjugular liver biopsy is rarely associated with major complications such as perforation of the hepatic capsule or cholangitis.

Magnitude of Effect: Good evidence for uncommon but serious harms.

Study Design: Randomized controlled trials and observational studies.

Internal Validity: Fair.

Consistency: Multiple studies, large number of participants.

External Validity: Good.

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