The Bristol and Severn Hepatitis C ODN, in partnership with SWAG, have been selected for an NHS Cancer Programme pilot project aiming to achieve earlier detection of liver cirrhosis and liver cancer.
The main risk factor for primary hepatocellular carcinoma (HCC) is cirrhosis (scarring) of the liver, which can often go undiagnosed for many year years before symptoms develop. Many of us are at risk of cirrhosis due to alcohol misuse, type 2 diabetes, obesity, or viral hepatitis. Earlier diagnosis leads to better outcomes in hepatocellular cancer, so we offer 6 monthly surveillance for HCC in our cirrhosis patients. We hope that by making earlier diagnosis of cirrhosis we will be able to support earlier diagnosis of HCC and better outcomes for our patients. It will also allow them to optimise their cirrhosis care and engage with our hepatology services.
The team have developed an outreach programme called ‘Alright My Liver?’ which will involve a specialist team offering screening for liver disease via a short risk factor assessment followed by capillary blood tests for viral hepatitis and/or a FibroScan. FibroScan is a quick, non-invasive bedside scan which can rule out or indicate liver cirrhosis. Service users with concerning results will be referred directly into hepatology services for clinical review and cancer surveillance. We have been fortunate to appoint a clinical nurse specialist to co-ordinate the service and hope soon to appoint a hepatology support worker who will be proactive in supporting our patients to overcome barriers to attending appointments.
Whilst the ‘Alright My Liver?’ sessions are open to everyone, we are trying to get the service out to communities who most need it. We are working closely alongside addiction services in order to best engage people who might be at the highest risk of alcohol-related liver disease and viral hepatitis. We are collaborating with Caafi Health to improve our reach into ethically diverse communities in the region and support us in overcoming language barriers to engagement. We are also linking in with primary care services and diabetic medicine teams. There is a strong link between liver disease and deprivation, and we are committed to offering an inclusive and flexible service.