Cancer Screening & Awareness

Cancer Screening /
Saves Lives.
Know the Signs.

Clear, evidence-based screening information for gastrointestinal, liver, and pancreatic cancers — put together by a surgeon who has seen what early detection can mean for a family.

This resource is for educational purposes only. Always consult your physician for personalised medical advice.

90%+
5-year survival when colorectal cancer is caught early
3×
More treatable liver cancer when detected at stage I vs III
40%
Of GI cancer deaths are potentially preventable with screening
1 in 5
Indians at high risk for a GI cancer in their lifetime

A Surgeon Committed to Early Detection

I am Dr. Raghunandan Dixit, a GI and Hepatobiliary Surgeon specialising in liver transplantation and complex abdominal oncology at the All India Institute of Medical Sciences (AIIMS). With years of experience in high-stakes surgical care — Whipple procedures, hepatectomies, and advanced pancreatic interventions — I have seen first-hand what a difference early detection makes.

The Hope to Heal exists because most gastrointestinal cancers are silent until they are advanced. My goal is to put clear, evidence-based screening information directly in the hands of patients and families — in language that empowers rather than overwhelms.

My clinical and research interests include predicting post-hepatectomy liver failure, surgical outcomes in pancreatic disease, and applying machine learning to surgical risk stratification. I believe the future of cancer care is built on two pillars: surgical excellence and proactive screening.

Areas of Expertise

Hepatobiliary Surgery

Complex liver resections, biliary reconstruction, and hepatectomy for primary and metastatic disease.

Liver Transplantation

Deceased and living-donor liver transplant at one of India's premier transplant centres.

Pancreatic Surgery

Whipple procedures, distal pancreatectomy, and management of pancreatic tumours and cysts.

Surgical Research

Machine learning models for predicting post-operative outcomes, systematic reviews, and meta-analyses.

Cancer Screening, Explained Clearly

Evidence-based guidance on when to screen, what tests to choose, and which warning signs should prompt urgent evaluation — written for patients and families.

Colorectal Cancer

Colon & Rectal Cancer Screening

Colorectal cancer is one of the most preventable cancers when polyps are detected and removed before they become malignant. Routine screening can reduce both incidence and mortality substantially.

Warning Signs

  • Blood in or on the stool, or rectal bleeding
  • Persistent change in bowel habits (diarrhoea, constipation, or narrow stools)
  • Persistent abdominal discomfort (cramps, gas, or pain)
  • Feeling that the bowel does not empty completely
  • Unexplained weight loss
  • Unexplained iron-deficiency anaemia or fatigue

Who Should Start Screening

  • Average-risk adults: begin at age 45–50
  • First-degree relative with colorectal cancer: begin at 40 or 10 years before their diagnosis age, whichever is earlier
  • Personal history of colorectal polyps: earlier and more frequent surveillance
  • Inflammatory bowel disease (Crohn's or ulcerative colitis): surveillance from 8–10 years after onset
  • Hereditary syndromes (FAP, Lynch syndrome): genetic counselling and early colonoscopy

Recommended Screening Tests

Colonoscopy Every 10 years

The gold standard. Allows direct visualisation of the entire colon with simultaneous polypectomy. Requires bowel preparation.

FIT (Faecal Immunochemical Test) Every 1–2 years

Non-invasive home stool test detecting hidden blood. Positive results require follow-up colonoscopy.

Flexible Sigmoidoscopy Every 5 years

Examines the lower third of the colon. Less preparation required but misses proximal lesions.

CT Colonography Every 5 years

Non-invasive CT scan of the colon. Useful for patients unfit for colonoscopy. Still requires bowel preparation.

Liver & Hepatocellular Carcinoma

Liver Cancer (HCC) Screening

Hepatocellular carcinoma almost always arises in the setting of chronic liver disease. Six-monthly surveillance in high-risk individuals dramatically improves the chance of curative treatment.

Warning Signs

  • Right upper abdominal pain or a palpable mass
  • Significant unexplained weight loss
  • Jaundice (yellowing of skin and eyes)
  • Ascites (new abdominal swelling due to fluid)
  • Sudden deterioration in a known cirrhotic patient
  • Fever and night sweats without infection

High-Risk Groups for Surveillance

  • Any cause of cirrhosis (viral, alcoholic, metabolic)
  • Chronic Hepatitis B carriers — even without cirrhosis
  • Chronic Hepatitis C with advanced fibrosis
  • Non-alcoholic fatty liver disease (NAFLD) with advanced fibrosis or NASH
  • Family history of HCC in a first-degree relative

Recommended Screening Tests

Abdominal Ultrasound Every 6 months

First-line surveillance tool. Safe, inexpensive, and widely available. Sensitivity improves significantly with AFP co-testing.

Serum AFP (Alpha-Fetoprotein) Every 6 months

Blood tumour marker used alongside ultrasound. Rising AFP trend is clinically significant even without a discrete lesion.

Triphasic CT / MRI Liver Diagnostic (as indicated)

Used when ultrasound detects a nodule ≥1 cm. Characteristic enhancement patterns allow diagnosis without biopsy in most cases.

LI-RADS Radiological scoring

Liver Imaging Reporting and Data System — standardises risk stratification of liver nodules from LR-1 (benign) to LR-5 (definite HCC).

Pancreatic Cancer

Pancreatic Cancer Screening

Pancreatic cancer has one of the lowest survival rates because it is usually detected late. General population screening is not yet recommended, but targeted surveillance for high-risk individuals offers meaningful benefit.

Warning Signs

  • Painless jaundice (yellowing without abdominal pain — a red flag)
  • New-onset diabetes mellitus after age 50 without obvious cause
  • Mid-back or epigastric pain radiating to the back, worse when lying flat
  • Steatorrhoea (greasy, pale, floating stools) from exocrine insufficiency
  • Significant unexplained weight loss and anorexia
  • Unexplained venous thromboembolism (DVT or PE)

High-Risk Groups for Surveillance

  • Two or more first-degree relatives with pancreatic cancer
  • Known germline mutation: BRCA2, PALB2, ATM, or Lynch syndrome (MLH1/MSH2)
  • Peutz-Jeghers syndrome
  • Hereditary pancreatitis
  • Familial Atypical Multiple Mole Melanoma (FAMMM — CDKN2A mutation)
  • New-onset diabetes mellitus over age 50 with weight loss

Recommended Screening Tests

Endoscopic Ultrasound (EUS) Annually

Highly sensitive for detecting small pancreatic lesions and cysts. Allows fine-needle aspiration if a lesion is detected.

MRI / MRCP Annually (alternating with EUS)

Excellent for pancreatic parenchyma and ductal anatomy. No radiation. Preferred in younger high-risk individuals.

CA 19-9 + CEA (serum) Adjunct marker

Not reliable for population screening but useful for monitoring known cysts or as a complement to imaging in high-risk groups.

Genetic Counselling One-time assessment

Essential for families with multiple affected relatives or known mutation carriers. Guides entry into formal surveillance programmes.

Gastric Cancer

Gastric Cancer Screening

Gastric cancer remains a leading cause of cancer death in Asia. Eradication of H. pylori in high-risk individuals and surveillance of pre-malignant lesions can substantially reduce incidence.

Warning Signs

  • Dysphagia (difficulty swallowing) or odynophagia
  • Persistent indigestion or heartburn not responding to treatment
  • Upper abdominal pain or epigastric discomfort
  • Early satiety (feeling full after a small meal)
  • Unexplained weight loss or loss of appetite
  • Haematemesis (vomiting blood) or melaena (dark tarry stools)

Risk Factors

  • H. pylori infection — the most important modifiable risk factor
  • Family history of gastric cancer in a first-degree relative
  • Pernicious anaemia or autoimmune gastritis
  • Gastric polyps or intestinal metaplasia on prior endoscopy
  • Heavy tobacco use combined with high-salt, low-vegetable diet
  • Unexplained dyspepsia in patients over 40 with alarm features

Recommended Screening Tests

Upper GI Endoscopy (OGD) As clinically indicated

The definitive diagnostic tool. Allows direct visualisation, biopsy, and detection of pre-malignant lesions including intestinal metaplasia.

H. pylori Testing & Eradication Once — then treat if positive

Urea breath test, stool antigen, or biopsy. Eradication reduces gastric cancer risk by up to 35% in high-risk populations.

Serum Pepsinogen I/II Ratio Adjunct marker

Low PGI or low PGI/PGII ratio indicates atrophic gastritis, a precursor lesion. Used for risk stratification before endoscopy.

Surveillance Endoscopy Every 3 years after intestinal metaplasia

Patients with confirmed intestinal metaplasia or low-grade dysplasia require structured surveillance to detect malignant transformation.

For colorectal cancer, average-risk adults should begin screening at age 45–50. For liver cancer, screening is risk-based and reserved for those with cirrhosis or chronic hepatitis B, regardless of age. Pancreatic and gastric cancer screening is not recommended for the general population; guidelines focus on individuals with specific risk factors or alarm symptoms.

The most important step is to speak with your physician about your personal risk profile — family history, lifestyle factors, and existing conditions all influence when and how to screen.

Most patients experience little or no pain during the procedure because it is performed under conscious sedation or general anaesthesia. The preparation the night before — a bowel-cleansing solution — is often described as the least comfortable part.

The procedure itself typically takes 20–45 minutes. You will need someone to drive you home afterwards due to the sedation. Most people return to normal activities the following day.

A positive FIT test does not mean you have cancer. Only around 5–10% of people with a positive FIT are ultimately found to have colorectal cancer; the majority have benign causes such as haemorrhoids, polyps, or small tears.

However, a positive result must be followed up promptly with a colonoscopy. Do not delay — this is how the test is designed to work, catching any problem at an early, treatable stage.

Yes. Chronic hepatitis B is one of the strongest risk factors for hepatocellular carcinoma (HCC), even in the absence of cirrhosis. The annual risk is estimated at 0.1–0.8% in non-cirrhotic carriers and rises substantially once cirrhosis develops.

International guidelines recommend six-monthly liver ultrasound and AFP testing for all hepatitis B carriers. Maintaining antiviral therapy and regular follow-up with a hepatologist or hepatobiliary surgeon is essential.

Occasional indigestion after a heavy meal is common and usually benign. The alarm features that warrant prompt medical attention include: onset after age 55, unexplained weight loss of ≥5 kg, progressive difficulty swallowing, persistent vomiting, haematemesis (blood in vomit), melaena (black tarry stools), or a palpable abdominal mass.

If any of these features are present alongside dyspepsia, do not wait. Arrange urgent evaluation, ideally with an upper GI endoscopy.

Simple fatty liver (NAFL) carries a very low cancer risk. However, when fatty liver progresses to non-alcoholic steatohepatitis (NASH) and significant fibrosis (stage F3–F4), the risk of hepatocellular carcinoma increases meaningfully — and can occur even without established cirrhosis.

Patients with NASH-related advanced fibrosis or cirrhosis should be enrolled in six-monthly HCC surveillance. The best protection is treating the underlying metabolic risk factors — weight, diabetes, and dyslipidaemia.

You can register for an OPD appointment at AIIMS New Delhi directly through the hospital's online portal or by visiting the registration counter. No formal external referral is mandatory for OPD consultation at AIIMS.

Alternatively, you are welcome to use the contact form on this page to send an enquiry directly. Please include any relevant imaging or reports so we can advise appropriately before the appointment.

Please bring all recent imaging (CT scans, MRI, ultrasound reports) with the actual films or CDs — not just the printed reports. Bring blood test results including liver function tests, full blood count, and tumour markers such as AFP or CA 19-9 if already done.

Also bring a list of all current medications and their doses, any previous hospital discharge summaries, biopsy reports if a tissue diagnosis has been made, and a clear written summary of your symptoms and how long they have been present. A family member or close friend is welcome to accompany you.

Selected Publications

Peer-reviewed research in hepatobiliary surgery, pancreatic oncology, and the application of data science to surgical outcomes.

Original Research

Predicting Post-Hepatectomy Liver Failure Using Machine Learning: A LightGBM Model

Journal of Hepatobiliary Surgery · 2025

A prospective cohort study developing and validating a machine learning model (LightGBM) for pre-operative prediction of post-hepatectomy liver failure, using clinical, volumetric, and biochemical variables from a tertiary AIIMS dataset.

Machine Learning Hepatectomy Outcomes

Systematic Review

Surgical Outcomes After Whipple Procedure in India: A Systematic Review and Meta-Analysis

Indian Journal of Gastroenterology · 2024

Pooled analysis of pancreaticoduodenectomy outcomes across Indian centres, examining 30-day morbidity, mortality, and oncological outcomes, with sub-group analyses by centre volume and operative technique.

Pancreatic Cancer Whipple Meta-Analysis

Clinical Study

Perioperative Outcomes of Laparoscopic vs Open Right Hepatectomy: Matched Cohort Analysis

HPB (Oxford) · 2024

Propensity score-matched analysis comparing laparoscopic and open right hepatectomy for HCC and metastatic disease — evaluating blood loss, hospital stay, complication rates, and 90-day mortality.

Laparoscopic Liver Resection HCC
Request Full Publication List

Reach Out

For patient referrals, research enquiries, second opinions, or to schedule a consultation at AIIMS, please use the form or contact details below.

AIIMS New Delhi

Department of Surgical Gastroenterology
All India Institute of Medical Sciences
Ansari Nagar, New Delhi — 110029

OPD Hours

Monday – Saturday
9:00 AM – 1:00 PM

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