Missed Diagnosis in Alcohol-Related Hepatocellular Carcinoma: A Call for Alcohol Consumption and Liver Disease Early Detection.

Alcohol-related hepatocellular carcinoma is an increasingly prevalent consequence of alcohol use and the often-silent progression of alcohol-related liver disease. A substantial proportion of patients with alcohol-related hepatocellular carcinoma are diagnosed at an advanced stage, frequently because underlying liver disease has not been previously identified and surveillance has not been implemented. This review summarizes recent epidemiological trends and clinical features of alcohol-related hepatocellular carcinoma, with a particular focus on the high proportion of undiagnosed cirrhosis and the challenges posed by alcohol use disorder, comorbidities and socioeconomic vulnerability. Strengthening collaboration between hepatology and addiction medicine, alongside population-level strategies to reduce alcohol use, will be essential to enhance surveillance uptake and ultimately improve outcomes in alcohol-related hepatocellular carcinoma.