A new initiative to deliver on-the-spot liver scans to check for cancer in high-risk communities has been rolled out as part of a major NHS drive to catch more cancers earlier and save lives.
The programme identifies those at risk of the most common form of liver cancer, hepatocellular carcinoma, which makes up 85% of all liver cancers.
Checks are being offered to adults with high levels of alcohol consumption, a current diagnosis or history of past viral hepatitis, or non-alcoholic liver disease.
Mobile trucks are visiting GP practices, recovery services, food banks, diabetes clinics, sexual health clinics and homeless shelters to perform quick, non-invasive scans.
In eight months – from June 2022 to January 2023 – more than 7,000 fibroscans were performed, identifying over 830 people with cirrhosis or advanced fibrosis – with the majority of those identified referred on to further care.
The trucks are expected to scan 22,000 people during the first year of the pilot scheme.
If caught early, patients have a 70-90% chance of survival for five years or more with treatment.
NHS staff are already visiting at-risk communities as part of the Hepatitis C Elimination Programme and the programme is being expanded to include a liver health check involving an on-the-spot fibrosis scan which detects liver damage.
Dame Cally Palmer, national cancer director for the NHS in England, said: ‘Building on the success of other community diagnostic schemes, like our lung trucks, this innovative surveillance programme is bringing life-saving checks to people who are at a higher risk of liver cancer, and who may have found it difficult to come forward or access health care otherwise.
‘The on-the-spot liver scans have already found that around one in 10 people in communities visited have advanced liver damage that needs further monitoring or treatment as it could lead to liver cancer. Ensuring these people are seen early and referred on for further testing will help us to diagnose cancers at an earlier stage.
‘We’ve already seen hundreds of people diagnosed at an earlier stage through our targeted lung cancer trucks, and now with the addition of NHS teams offering these vital liver checks in mobile trucks across the country, I urge anyone who is offered a scan in their community to take up the opportunity.’
Those who are deemed high risk will be provided with information about their level of risk and, where appropriate, will be referred to their GP. If needed, patients will be referred straight into a six-month liver surveillance care programme, where they will be partnered with a peer support worker who will continue to check in, as well as offer guidance and help informed by people who have experienced liver disease themselves.
‘Liver cancer can be hard to detect at an early stage and so these checks, for people who have been identified as higher risk, are an essential part of the NHS’s action to find more people with cancer – and in groups that may otherwise find it hard to access life-saving tests,’ Professor Peter Johnson, NHS clinical director for cancer, explained
‘There are diseases that we know increase the risk of liver cancer, which is why the liver trucks will be visiting particular treatment clinics.
‘Lives are saved when cancers are caught early and when more people are referred for tests, which is why the NHS has put so much effort into early diagnosis in recent years, as well as increasing access to testing.’
Symptoms of liver cancer include unexpected weight loss, loss of appetite, vomiting blood, and pain or swelling of the abdomen.
Nathan Motherwell, a peer support worker who works for the Hepatitis C Trust in support of the Hepatitis C Elimination Programme, said he likely had hepatitis C for around 12 years before being diagnosed.
Speaking about the success of the Hep C Elimination Programme, he said: ‘Thanks to our targeted approach to supporting these at-risk communities, we have developed a strong rapport with them which has encouraged more people who otherwise would be reluctant, to come forward for potentially life-saving scans on the community vans.
‘Our refer-a-friend scheme has also increased the number of people coming forward for scans and helped identify more people with hepatitis C, so that they can get the treatment they need sooner – this shows how impactful a relatable face can be and we hope to replicate this success with the liver check expansion.’