A contemporary review of care gaps in hepatocellular carcinoma surveillance.

INTRODUCTION: Hepatocellular carcinoma (HCC) is a leading cause of morbidity and mortality in patients with cirrhosis and carries a substantial public health burden. Primary liver cancer is the sixth most common cancer worldwide. Despite guideline recommendations for HCC surveillance, pooled surveillance rates are around 18%. Further, racial, ethnic, and socioeconomic disparities exist. Along the HCC care continuum, care gaps exist from access to care, to surveillance, and ultimately in linkage to treatment. AREAS COVERED: A literature search was performed utilizing PubMed to review peer-reviewed articles published from 2000 to present. Key landmark studies are reviewed highlighting the care gaps in cirrhosis management, HCC surveillance, and treatment. These studies underscore the complex interplay of systems, provider, and patient level factors that influence care gaps experienced by patients with HCC. EXPERT OPINION: Despite low adherence to HCC surveillance and care gaps, there are several opportunities to ensure equitable access to care while achieving personalized, precision medicine. Future efforts will need to focus on multi-disciplinary care while ensuring that providers are knowledgeable and able to provider culturally competent care.