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Last month, The Lancet posted online an article from Stine Johansen, Fredrik Åberg, Emmanuel Tsochatzis and Aleksander Krag, titled "Screening for Advanced Liver Disease." The article aims to update the Wilson and Jungner criteria, initially developed in 1960, to address modern needs and issues. In this conversation, Professor Krag and Dr. Johansen join Roger Green to discuss their article.
There are many nuances and high points to cover in this thoughtful, fairly lengthy conversation, but one key point is that screening a mass population for HCC or cirrhosis has an entirely different set of issues and criteria compared to the screening usually discussed on this podcast, which involves identifying a population at increased risk for MASLD or MASH and screening them. Also, healthcare is far more expensive than it was in 1960 with a plethora of high-cost ways to diagnose, treat and manage patients.
As a result, the authors started with the 10 Wilson and Jungner criteria and added eight more. During this conversation, Stine emphasizes the need for a comprehensive clinical trial on this issue, and all panelists agree that LiverAIM is likely to serve as the study.