Hepatocellular Carcinoma Surveillance: Challenging the status quo

In August 2023, Roche Diagnostics Australia hosted an information evening dedicated to exploring the current diagnostic tools and management criteria of liver cancer, also known as hepatocellular carcinoma (HCC), in Australia.

Secondary care clinicians (specialists) such as gastroenterologists, hepatologists, and oncologists from across Australia were invited to a thought-provoking HCC surveillance educational event in Melbourne.

In this engaging session, three Australian liver cancer experts shed light on the current standard of care in Australia, HCC surveillance strategies, and blood-based biomarkers to assist in early diagnosis.

Liver cancer in Australia

In Australia, incidence rates for all primary liver cancers have increased by 378% between 1982 and 2019 (1).

In 2020, a report commissioned by the Australian peak body the Liver Foundation, found liver cancer to be Australia's fastest-growing cause of cancer-related deaths (2). Some 85–90% of liver cancer occurs in individuals with cirrhosis of the liver3, which can result from a poor diet, excessive alcohol consumption, or infection by hepatitis. Worldwide, up to 1 in 4 cases of liver cancer are caused by hepatitis B and C infections. (4)

Roche is a world leader in providing both companion diagnostics and immunotherapies in the treatment of liver cancer. In the analysis of tumour biopsies, the BenchMark ULTRA PLUS system is a fully automated workflow for immunohistochemistry (IHC) and in-situ hybridization (ISH) tissue staining. 

Roche biomarkers can play a critical role in improving diagnosis and disease management. Roche also offers a number of serum biomarker-based models, including GAAD and GALAD algorithms, can be combined with ultrasound as a clinical diagnostic tool to diagnose early-stage HCC. 

Video Presentations

Video Presentations

Associate Professor Jessica Howell MBBS (Hons) FRACP PhD MSc (Epi) PGDip

Uncover the pressing issue of the rapidly increasing rates and evolving epidemiology of liver disease and HCC in Australia with A/Prof. Jessica Howell. She showcases the role that the HCC surveillance program has in improving patient survival, as well as the barriers to adherence. Gain a deeper understanding of how the indigenous population faces disproportionate challenges in HCC prevalence. A/Prof. Howell issues a call to action, emphasising the need to enhance equitable access to care and early detection strategies.


A/Prof. Jessica Howell MBBS (Hons) FRACP PhD MSc (Epi) PGDip PH is a gastroenterologist and Principal Research Fellow in the Department of Gastroenterology, St Vincent’s Hospital Melbourne/ University of Melbourne and co-head leads the Hepatitis B and Liver Cancer research group within the Disease Elimination program at Burnet Institute.


She combines clinical, basic science, epidemiological, and public health expertise in translational research projects in liver cancer and viral hepatitis, focused on marginalised populations. She currently leads several national and international multi-centre studies in rapid point-of-care diagnostics, novel biomarker development, and health system interventions in viral hepatitis and liver cancer. She is also a regular invited panellist for multiple national and international clinical guidelines and a technical advisor to the WHO (World Health Organisation).


 Associate Professor Simone Strasser

Join A/Prof. Simone Strasser as she takes you on a journey through the evolving landscape of HCC Surveillance. Delve into the realm of emerging biomarkers as She discusses the potential use of emerging protein biomarkers such as CPC3, OPN, in addition to the GAAD/GALAD algorithms (Gender, Age, [AFP-L3], AFP and DCP), as a promising tool for early-stage HCC detection.


A/Prof. Simone Strasser is a Senior Staff Specialist in the AW Morrow Gastroenterology and Liver Centre, and the Australian National Liver Transplant Unit at Royal Prince Alfred Hospital (RPAH) and the University of Sydney in Sydney, Australia.


She is a member of the Educational Committee of the International Liver Cancer Association (ILCA), Past President of the Gastroenterological Society of Australia (GESA), and a previous member of the Executive Council of the Asian Pacific Association for the Study of the Liver (APASL). She is currently the Director of the Liver Foundation, a community based organisation that aims to raise awareness and improve the lives of people living with liver disease.


A/Prof Strasser has a major clinical and research interest in primary liver cancer, viral hepatitis, non-alcoholic fatty liver disease, advanced liver disease, and liver transplantation. She is Director of Hepatology Clinical Trials at RPAH and chairs the RPAH Liver Cancer MDT (Medical Directed Therapy).

Dr. Manfred Spanger

Dr. Manfred Spanger unveils the intricacies of HCC Surveillance using ultrasound, CT and MRI. While guidelines provide a framework, he delves into the complexities that arise due to patient diversity. He explores the variability in ultrasound visualisation scores, influenced by factors like sonographers, probe angles, and organ views. Gain insights into the ongoing challenges and nuances of implementing consistent and effective ultrasound-based surveillance and exploring additional screening methods such as CT and MRI.


Dr. Manfred Spanger is an interventional radiologist working in Melbourne. He has a particular focus on the use of imaging technology to guide the treatment of cancer.


He trained originally as a diagnostic radiologist and then obtained further training and qualifications in interventional radiology, which is the procedural arm of radiology.


Dr. Spanger has been an investigator in a range of liver cancer trials, both primary and secondary. He spends about half his time managing a range of cancers, mostly in the liver. He is an expert in locoregional therapy for liver cancer, both arising in the liver and growing in the liver from cancers elsewhere. Dr. Spanger has treated hundreds of patients with radioembolisation, liver-directed chemoembolisation, and ablation.


About the evening

The video recording above captures three presentations at the event that deepen our understanding of HCC surveillance within an Australian context.

The event's core focus lies in illuminating the shifting epidemiology of HCC and, in particular, addressing the challenges inherent in HCC surveillance. It serves as an invaluable resource for clinicians specialising in HCC, providing a comprehensive understanding of the current landscape and the potential strategies for enhancing early detection and patient outcomes.



Reference 1 - (accessible as of 23 August 2023)

Reference 2 - (accessible as of 28 August 2023)

Reference 3 - (accessible as of 28 August 2023)

Reference 4 - (accessible as of 28 August 2023)


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