The Pearl study aims to recruit 3000 people with liver cirrhosis caused by one of the following underlying conditions: 

• Hepatitis C
• Hepatitis B
• Alcohol-related liver disease
• Metabolic dysfunction-associated steatotic liver disease (MASLD)
• Haemochromatosis

Participants can have never been diagnosed with HCC. Participants will be recruited from over 40 NHS sites throughout the UK and will be asked to attend at least 3 study visits. After their final study visit, they will be followed up via their medical history for up to 10 years using data collected by NHS England and the NHS Central Register for Scotland. Pearl will collect blood and urine samples along with clinical and imaging data at the study visits.

It is expected that during the four-year follow-up period around 100 Pearl patients will be diagnosed with HCC. The study’s aim is to assess whether specific technologies (including genetic, protein and other biomarkers as well as imaging markers) for the early detection of HCC as identified in the related SELiNa study, are able to detect liver cancer at the earliest stages when curative therapies may be applied and to develop new prediction models to identify patients at most at risk of developing HCC.

There are currently 44 sites recruiting to the Pearl study across England and Scotland as shown in the map below.