الفهرس 
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Abstract
Hepatocellular carcinoma is a major complication of chronic liver diseases and had the poorest diagnosis.
• The incidence of hepatocellular carcinoma is 5.3% which is higher than in western countries and lower than eastern countries
• Surveillance for HCC results in detection of smaller lesions before development of portal vein thrombosis or extrahepatic spread while the patient had good liver functions which give the patients better chance for curative treatment.
• Addition of alpha fetoprotein to ultrasound examination results in significant increase in the efficacy of screening program.
• The cost/ QALY for HCC detected by screening by ultrasound alone 7,907 EGP while adding alpha fetoprotein to ultrasound examination costs 8,430 EGP.
• ICER by screening by ultrasound alone is 5,987 EGP when screening done by ultrasound alone, while by ultrasound and AFP is 6,430 EGP.
• Either screening by ultrasound alone or by ultrasound with alpha fetoprotein is cost effectiveness in Egypt.