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NHS to Roll out Liver Cancer Checks for High Risk Communities

NHS England (NHSE) has announced a new campaign to scour communities at high risk to check for liver cancer. The initiative will deploy "roaming trucks" to perform on-the-spot, rapid non-invasive fibroscans to identify those at risk of the most common form of liver cancer, hepatocellular carcinoma, which makes up 85% of all liver cancers.

The mobile units will be sent to GP practices, recovery services, food banks, diabetes clinics, sexual health clinics and homeless shelters as part of a major NHS drive to catch more cancers at an earlier stage. Checks will be offered to adults with known factors that increase the risk of developing liver cancer, including high levels of alcohol consumption, a current diagnosis or history of past viral hepatitis, or non-alcoholic liver disease.

Professor Peter Johnson, NHS clinical director for cancer, said: "Liver cancer can be hard to detect at an early stage and so these checks, for people who have been identified as higher risk, are an essential part of the NHS's action to find more people with cancer – and in groups that may otherwise find it hard to access lifesaving tests.

"There are diseases that we know increase the risk of liver cancer, which is why the liver trucks will be visiting particular treatment clinics. 

"Lives are saved when cancers are caught early and when more people are referred for tests, which is why the NHS has put so much effort into early diagnosis in recent years, as well as increasing to access to testing."

'Innovative Surveillance Programme'

Dame Cally Palmer, national cancer director for the NHS in England, said: "Building on the success of other community diagnostic schemes, like our lung trucks, this innovative surveillance programme is bringing lifesaving checks to people who are at a higher risk of liver cancer, and who may have found it difficult to come forward or access health care otherwise."

Trucks already deployed over an 8-month pilot from June 2022 to January 2023 performed more than 7000 fibroscans and identified over 830 people with cirrhosis or advanced fibrosis, leading causes of liver cancer. The majority of those identified were referred on for further care.

The units are expected to visit high-risk communities across the country and scan another 22,000 people in the community during the first year of the pilot scheme. The programme is an expansion of the existing Hepatitis C Elimination Programme, which aims to put England "in pole position to be among the first countries in the world to eliminate the virus as a public health concern".

Already this has "dramatically reduced" death rates 5 years ahead of global targets, NHSE reported in December, as well as "drastically reducing the number of people seeking liver transplants due to hepatitis C".

Catching Cases Earlier Improves Survival

Launching the new liver scan initiative, NHSE said that currently around 6100 people are diagnosed with liver cancer each year. The number of cases has doubled over the past decade and is expected to continue to rise.

Until now, only 1 in 3 liver cancers has been diagnosed at an early stage, and it is hoped that the new scanning programme will help catch more cases earlier, improving survival prospects. If caught early, patients have a 70-90% chance of survival for 5 years or more with treatment.

Dame Cally said: "The on-the-spot liver scans have already found that around 1 in 10 people in communities visited have advanced liver damage that needs further monitoring or treatment as it could lead to liver cancer – ensuring these people are seen early and referred on for further testing will help us to diagnose cancers at an earlier stage.  

"We've already seen hundreds of people diagnosed at an earlier stage through our targeted lung cancer trucks, and now with the addition of NHS teams offering these vital liver checks in mobile trucks across the country, I urge anyone who is offered a scan in their community to take up the opportunity."

Vanessa Hebditch, director of policy at the British Liver Trust, welcomed the scanning drive. "We are delighted to have been working closely with NHS England on this initiative. Liver cancer is the fastest rising cause of cancer death in the UK and most patients will be diagnosed after an emergency admission to hospital. It is also most common in people who already have liver disease, especially if they have cirrhosis of the liver.

"This is why finding people with early stage liver disease is vital so they can get the treatment and support they need to improve their liver health, reducing their chance of developing liver cancer."