Clinical impact of screening first-degree relatives of patients with hepatocellular carcinoma.

Family history is a risk factor for hepatocellular carcinoma (HCC). However, the risk of first-degree relatives is not known. To investigate the risk of HCC among the first-degree relatives of probands and whether screening can lead to early diagnosis of HCCs in these relatives, we conducted a screening program. The probands' first-degree relatives who were >20 years old were included. Serum aminotransferase, hepatitis viral marker, alpha-fetoprotein, and abdominal sonography were done. HCCs were found in 20 (1.9%) of the 1,046 first-degree relatives, especially in the male siblings. Eighty-five percent of these 20 HCC patients were hepatitis B virus carriers. Forty percent of these 20 HCC patients had tumors <5 cm. Approximately 55% of these 20 HCCs were resectable. The 1-year survival rate in these 20 HCC patients with resectable HCCs was 72.7%. However, the overall 1-year survival rate was only 40%. We found HCC in 1.9% of the first-degree relatives of HCC patients. The male relatives, especially the older brothers, were the group at highest risk. The familial HCCs were closely related to the hepatitis B virus infection. To detect HCCs early, initial screening should be done as early as possible on the HCC family members.