Introduction and purpose of the work. Hepatocellular carcinoma (HCC) is one of the most common malignant tumours all over the world. It is considered to be the sixth malignant tumour in terms of incidence. It is also characterized by high mortality rate, which, depending on the geographic region, gives the second or third place on the list of cancer related death. There are many known risk factors for the development of hepatocellular carcinoma, the most important of which is liver cirrhosis. Thus the cirrhotic patients are generally accepted for screening. Actually it is recommended to perform abdominal ultrasound every 6 months in this group. Other forms of screening are also tested.

Description of the current knowledge and conclusions.

Literature review provides indisputable evidences for the need of screening for liver cancer. Doubts remain only about the appropriateness of widening the screening group and possibly extending the scope of diagnostic tools.

The authors, by analyzing the available knowledge for hepatocellular carcinoma screening, consider the qualification of actually recommended screening tests to be insufficient in countries with high incidence. Relatively high incidence of HCC, even greater mortality in the context of all cancers, safety, low cost and universal access to ultrasound, should, in the opinion of the authors, be enough for the consideration to widen the screening guidelines in countries with high incidence of HCC. In countries with low incidence, e.g. in Poland, the screening in healthy population do not belong to the priority.

Dimitroulis D, Damaskos C, Valsami S, Davakis S, Garmpis N, Spartalis E, et al.. From diagnosis to treatment of hepatocellular carcinoma: An epidemic problem for both developed and developing world. World J Gastroenterol. 2017; 7; 23 (29): 5282-5294.

Bellissimo F, Pinzone MR, Cacopardo B, Nunnari G. Diagnostic and therapeutic

management of hepatocellular carcinoma. World J Gastroenterol. 2015; 14; 21 (42): 12003-12021.

Limaiem F, Bouhamed M, Sahraoui G, Mzabi S. Hepatocellular carcinoma: a

clinicopathological study of 64 cases. Pan Afr Med J. 2017; 16; 27:41.

Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008; 8; 371 (9615): 838-851.

Massarweh NN, El-Serag HB. Epidemiology of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma. Cancer Control. 2017; 24 (3): 1073274817729245. doi: 10.1177/1073274817729245.

Chen S, Duan W, You H, Jia J. A brief review on prognostic models of primary

biliary cholangitis. Hepatol Int. 2017; 14. doi: 10.1007/s12072-017-9819-9.

Singh S., Talwalkar J.A. Primary sclerosing cholangitis: Diagnosis, prognosis, and management. Clin. Gastroenterol. Hepatol. 2013; 11:898–907. doi: 10.1016/j.cgh.2013.02.016.

Zhou WC, Zhang QB, Qiao L. Pathogenesis of liver cirrhosis. World J

Gastroenterol. 2014; 21; 20 (23):7312-7324.

Naschitz JE, Slobodin G, Lewis RJ, Zuckerman E, Yeshurun D. Heart diseases

affecting the liver and liver diseases affecting the heart. Am Heart J. 2000; 140 (1): 111-120.

Keng VW, Largaespada DA, Villanueva A. Why men are at higher risk for

hepatocellular carcinoma? J Hepatol. 2012; 57 (2): 453-454.

Kumar M, Kumar R, Hissar SS, Saraswat MK, Sharma BC, Sakhuja P, Sarin SK. Risk

factors analysis for hepatocellular carcinoma in patients with and without

cirrhosis: a case-control study of 213 hepatocellular carcinoma patients from

India. J Gastroenterol Hepatol. 2007; 22 (7): 1104-1111.

Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in

cirrhosis: incidence and risk factors. Gastroenterology. 2004; 127 (5 Suppl.

: S35-50.

Fateen W, Ryder SD. Screening for hepatocellular carcinoma: patient selection

and perspectives. J Hepatocell Carcinoma. 2017; 17; 4: 71-79.

Kuo MJ, Chen HH, Chen CL, Fann JC, Chen SL, Chiu SY, et al. Cost-effectiveness analysis of population-based screening of hepatocellular carcinoma: Comparing ultrasonography with two-stage screening. World J Gastroenterol. 2016; 28; 22 (12):m 3460-3670.

Ungtrakul T, Mahidol C, Chun-On P, Laohapand C, Siripongsakun S,

Worakitsitisatorn A, et al. Hepatocellular carcinoma screening and surveillance in 2293 chronic hepatitis B patients in an endemic area. World J Gastroenterol. 2016; 14; 22 (34): 7806-12.

Singal A, Conjeevaram H, Volk N, Fu S, Fontana R, Askari F, et al. Effectiveness of Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis. Cancer Epidemiol Biomarkers Prev. 2012; OF1-7. DOI: 10.1158/1055-9965.EPI-11-1005.

Blehar DJ, Barton B, Gaspari RJ. Learning curves in emergency ultrasound

education. Acad Emerg Med. 2015; 22 (5): 574-582.

Andoulo F A, Noah DN, Djapa R, Kowo M, Talla P, Medjo EH et al. Epidemiology of hepatitis C: related hepatocellular carcinoma in Cameroon. Pan Afr Med J. 2014; 15; 19:379. doi: 10.11604/pamj.2014.19.379.4143.

Bellissimo F, Pinzone MR, Cacopardo B, Nunnari G. Diagnostic and therapeutic

management of hepatocellular carcinoma. World J Gastroenterol. 2015;

; 21 (42): 12003-21. doi: 10.3748/wjg.v21.i42.12003.

El-Serag HB, Davila JA. Surveillance for hepatocellular carcinoma: in whom and

how? Therap Adv Gastroenterol. 2011; 4 (1): 5-10.

Park JH, Park MS, Lee SJ, Jeong WK, Lee JY, Park MJ, et al. Contrast-enhanced US with Perfluorobutane (Sonazoid) used as a surveillance test for Hepatocellular Carcinoma (HCC) in Cirrhosis (SCAN): an exploratory cross-sectional study for a diagnostic trial. BMC Cancer. 2017; 18; 17 (1): 279. doi: 10.1186/s12885-017-3267-8.

Kudo M. Defect Reperfusion Imaging with Sonazoid®: A Breakthrough in

Hepatocellular Carcinoma. Liver Cancer. 2016; 5 (1): 1-7.

Singh GK, Jemal A. Socioeconomic and Racial/Ethnic Disparities in Cancer

Mortality, Incidence, and Survival in the United States, 1950-2014: Over Six

Decades of Changing Patterns and Widening Inequalities. J Environ Public Health.

; 2017: 2819372. doi: 10.1155/2017/2819372.

Singh GK, Siahpush M, Altekruse SF. Time trends in liver cancer mortality,

incidence, and risk factors by unemployment level and race/ethnicity, United

States, 1969-2011. J Community Health. 2013; 38 (5): 926-940.

Jemal A, Ward EM, Johnson CJ, Cronin KA, Ma J, Ryerson B, et al. Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival. J Natl Cancer Inst. 2017; 1; 109 (9). doi: 10.1093/jnci/djx030.

Yuen MF, Tanaka Y, Fong DY, Fung J, Wong DK, Yuen JC, et al. Independent risk factors and predictive score for the development of hepatocellular carcinoma in chronic hepatitis B. J Hepatol. 2009; 50 (1): 80-88.

Wong VW, Chan SL, Mo F, Chan TC, Loong HH, Wong GL, et al. Clinical scoring system to predict hepatocellular carcinoma in chronic hepatitis B carriers. J Clin Oncol. 2010, 1; 28 (10): 1660-1665.

Ganne-Carrié N, Layese R, Bourcier V, Cagnot C, Marcellin P, Guyader D, et al. ANRS CO12 CirVir Study Group. Nomogram for individualized prediction of hepatocellular carcinoma occurrence in hepatitis C virus cirrhosis (ANRS CO12 CirVir). Hepatology. 2016; 64 (4): 1136-1147.

Conti F, Buonfiglioli F, Scuteri A, Crespi C, Bolondi L, Caraceni P, et al. Early occurrence and recurrence of hepatocellular carcinoma in HCV-related cirrhosis treated with

direct-acting antivirals. J Hepatol. 2016; 65 (4): 727-733.

Kozbial K, Moser S, Schwarzer R, Laferl H, Al-Zoairy R, Stauber R,

Stättermayer AF, et al. Unexpected high incidence of hepatocellular carcinoma in cirrhotic patients with sustained virologic response following interferon-free direct-acting antiviral treatment. J Hepatol. 2016; 65 (4): 856-858.

Cardoso H, Vale AM, Rodrigues S, Gonçalves R, Albuquerque A, Pereira P et al. High incidence of hepatocellular carcinoma following successful interferon-free antiviral therapy

for hepatitis C associated cirrhosis. J Hepatol. 2016; 65 (5): 1070-1071.

Walker M, El-Serag HB, Sada Y, Mittal S, Ying J, Duan Z, et al. Cirrhosis is under-recognised in patients subsequently diagnosed with hepatocellular cancer. Aliment Pharmacol Ther. 2016; 43 (5): 621-30.

Singal AG, Yopp A, S Skinner C, Packer M, Lee WM, Tiro JA. Utilization of

hepatocellular carcinoma surveillance among American patients: a systematic

review. J Gen Intern Med. 2012; 27 (7): 861-867.

Zoller H, Tilg H. Nonalcoholic fatty liver disease and hepatocellular carcinoma. Metabolism. 2016; 65 (8): 1151-1160.

Krgyrou C, Moris D, Vernadakis S. Hepatocellular carcinoma development in

non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Is it going to be the "Plague" of the 21st century? A literature review focusing on pathogenesis, prevention and treatment. J BUON. 2017; 22 (1): 6-20.

Charrez B, Qiao L, Hebbard L. Hepatocellular carcinoma and non-alcoholic

steatohepatitis: The state of play. World J Gastroenterol. 2016; 28; 22(8): 2494-2502.

Krzakowski M, Zieniewicz K, Habior A, Horban A, Olszewski W, Cianciara J, et al. Rak wątrobowokomórkowy — rozpoznanie i leczenie. Onkol. Prak. Klin. 2009; 5, 4: 125–140.

Pan J, Xin L, Ma YF, Hu LH, Li ZS. Colonoscopy Reduces Colorectal Cancer

Incidence and Mortality in Patients With Non-Malignant Findings: A Meta-Analysis.

Am J Gastroenterol. 2016; 111 (3): 355-465.

Świątkowski M, Meder A, Sobczyński L, Koza J, Szamocka M, Brudny J, Korenkiewicz J. Adenomas detected during screening colonoscopies in the years 2000-2009. Przegl. Gastroenterol. 2012 : Vol. 7, nr 5, s. 299-305.

Świątkowski M, Meder A, Sobczyński L, Koza J, Szamocka M, Brudny J. The screening program for the early colorectal cancer detection performed at the Gastroenterology Department of Nicolaus Copernicus University in Toruń Collegium Medicum in Bydgoszcz in 2000-2009. Gastroenterol. Pol. 2010: 17, 6: 410-415.