SCMSC’s Fatty Liver Surveillance Program

If you, or a loved one, has been diagnosed with Non-Alcoholic Fatty Liver Disease, you understandably want to monitor the condition closely.

After all, about 10% to 30% of people with this disease have an early stage of Hepatocellular Carcinoma (HCC) which is the third leading cause of cancer death in the United States, and growing yearly.

Southern California Multi-Specialty Center has a new, comprehensive surveillance program for non-alcoholic fatty liver disease to identify and intervene if the disease progresses to hepatocellular cancer.

This program was developed by one of the leading surgeons in the state of California. To find out if you or a loved one qualifies for this program call 818.900.6480 now.

If you want to understand the disease and the surveillance program in greater detail, keep reading. In this article we will discuss the risk factors, progression to cirrhosis, the role of alcohol and genetics, and provide details about the non-alcoholic fatty liver surveillance program.

Do you have fatty liver disease and don’t know it?

Fatty liver disease is silent by design. The liver has no pain receptors, which means significant damage can accumulate for years before any symptom appears. By the time most patients are diagnosed, the disease has already been progressing quietly in the background.

The question isn’t whether you feel sick. The question is whether your liver has already started down a path you haven’t been told about yet.

Could this be you? A simple risk check

Already scheduled for gallbladder surgery?

This one surprises most patients: if you’re already scheduled for gallbladder removal (cholecystectomy), you may be sitting on a major diagnostic opportunity.

Gallstone disease and fatty liver disease share nearly identical risk factors — obesity, diabetes, metabolic syndrome — which means a large percentage of patients coming in for gallbladder surgery also have undiagnosed liver disease. Because the surgeon already has direct visualization of your liver during the procedure, a small needle biopsy can be performed at the same time, at minimal additional risk, to definitively stage your liver health.

This single step — an opportunistic liver biopsy during a procedure you’re already having — can provide more accurate information about your liver than any blood test or imaging study alone. It tells us your exact fibrosis stage, whether NASH is present, and how urgently surveillance or intervention is needed.

If you have an upcoming abdominal surgery and any of the metabolic risk factors above, ask us about adding a liver assessment to your surgical plan. It could be the most important thing that happens in that operating room.

Why act now, before you have symptoms?

Liver cancer caught early — before symptoms appear, while it’s still a single small lesion — carries a 5-year survival rate above 70%. Liver cancer caught late, when it has grown or spread, carries a 5-year survival rate below 15%.

The cancer hasn’t changed. The outcome has — entirely because of when it was found.

There is no pain that tells you when fatty liver becomes NASH. No alarm that sounds when NASH becomes fibrosis. No symptom that announces the transition to cirrhosis. The only way to know where you are on that spectrum is to look — proactively, systematically, before anything goes wrong.

That is exactly what this program is designed to do.

The best time to evaluate your liver was years ago. The second best time is now.

The Prevalence of HCC in NAFLD

Non-Alcoholic Fatty Liver Disease (NAFLD) impacts more than 25% of the US and global population. About 25% of those individuals progress to nonalcoholic steatohepatitis (NASH). NASH can result in progressive hepatic fibrosis, cirrhosis, and hepatocellular carcinoma (HCC).

About 90% of patients diagnosed with NAFLD have steatosis that is relatively benign but has an overall low mortality rate of 6–8%. However, about 10-30% of those affected have an early stage form of NAFLD non-sympathetic autoimmune disease.

What This Means for You: In simpler terms, while a large portion of the population has “fatty liver,” the condition is a sliding scale. Most cases stay quiet and manageable (benign), but for about 1 in 4 people, the liver begins to transition from simple fat buildup to active inflammation (NASH). Left unmanaged, this inflammation can create internal scarring (fibrosis) that eventually leads to more serious risks like cirrhosis or liver cancer (HCC).

Our program is designed to identify exactly where you are on this timeline. By catching the “silent” transition from simple fat to active inflammation early, we can often halt or even reverse the damage before it reaches a critical stage.

Beyond the diagnosis: understanding MASLD and Hepatocellular Health

In the past, these conditions were often grouped under the broad umbrella of “Fatty Liver.” Today, by using the more precise framework of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), our specialists can look closer at the WHY behind the condition. Whether you are concerned about persistent inflammation or have been told you are at risk for hepatocellular complications, the shift to MASLD means we are looking at your liver health in the context of your whole body… your metabolism, your heart, and your lifestyle.

At SCMSC, we don’t just treat a diagnosis; we treat a person. If you’ve been searching for answers about liver scarring or disease progression, know that MASLD is a condition where early, expert intervention can make a profound difference. We are here to help you navigate from uncertainty to a clear, actionable plan for protection and recovery.

What is this new surveillance program?

As with other chronic noncirrhotic liver diseases, follow-up of NAFLD (Non-Alcoholic Fatty Liver Disease) patients should consist of monitoring biochemical, metabolic and body weight parameters every 6 months and performing abdominal ultrasound every 6 months.

At SCMSC enrollment in the inclusive surveillance program consists of the following:

• Ultrasound every 6 months for 2 years and then yearly after that
• Fasting bloodwork every 6 months for 2 years and then yearly after that
• Custom nutrition plan based on your specific dietary needs from our in-house specialty dietician
• Lifestyle modification plan
• Proprietary supplementation plan customized for each patient to promote liver regeneration and reversal of disease

The surveillance window: why 6 months matters

Research has shown that fibrosis — the internal scarring that drives this disease toward cirrhosis and cancer — can advance by a full stage in as little as two years. In some patients, the progression from early NASH to cirrhosis has been documented in under 24 months.

HCC has an estimated tumor doubling time of approximately 117 days, meaning a tumor can double in size roughly every 4 months. A 6-month surveillance interval is therefore the clinically validated sweet spot: short enough to catch tumors while they remain within curative size thresholds (under 2 cm), long enough to be practically sustainable for patients and health systems.

A once-yearly ultrasound doesn’t just create a gap in your monitoring. In a disease that moves this fast, it creates a blind spot wide enough for the trajectory of your liver health to change completely between visits — without anyone knowing.
This is precisely why the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver (EASL), and the Asian Pacific Association for the Study of the Liver (APASL) — three of the most respected liver disease organizations in the world — have independently arrived at the same conclusion: high-risk patients need liver surveillance every six months, not every twelve.

That consensus isn’t coincidence. It reflects decades of research showing that liver cancer in the setting of fatty liver disease grows quickly enough that a 12-month window is simply too long. Tumors that are detectable and curable at 6 months can be inoperable by 12. The difference between those two outcomes isn’t the cancer — it’s the calendar.

Our biannual ultrasound protocol exists for one reason: to make sure that when something changes in your liver, we find it while we can still do something about it.
Twice a year is not excessive. In this disease, it is the minimum responsible standard of care.

A precision, risk-stratified approach to fatty liver disease (MASLD)

At SCMSC, we do not treat fatty liver disease as a binary diagnosis.

We use a precision, risk-stratified model to determine which patients have simple steatosis and which may have metabolically active steatohepatitis (MASH/NASH) or early fibrosis — the stage of disease that carries long-term risk.

While many patients can be monitored safely using advanced blood-based markers and imaging tools, select individuals benefit from definitive histologic staging to guide long-term surveillance and prevention strategies.

Non-Alcoholic Fatty Liver Disease Q&A