Routine surveillance for Hepatitis C includes regular AFP and ultrasound. Which option best represents this?

• A. AFP alone
• B. Ultrasound alone
• C. CT scan annually
• D. AFP and Ultrasound

Answer: (D)

The main concept is that surveillance for hepatocellular carcinoma in hepatitis C relies on both imaging and a tumor marker, because they complement each other and together improve early detection. Ultrasound is a safe, practical imaging method used regularly to spot new or changing liver lesions, but it can miss small tumors and its accuracy can be limited by cirrhosis or body habitus. Alpha-fetoprotein (AFP) is a blood test that can indicate HCC, yet it isn’t sufficiently sensitive or specific when used alone—levels can be elevated for reasons other than cancer, and some tumors don’t raise AFP. Using both together increases the likelihood of identifying early-stage HCC, providing a better chance for effective treatment. CT scans, while informative, involve radiation, higher cost, and aren’t standard for routine surveillance in asymptomatic patients. So combining AFP with ultrasound best represents routine surveillance.