A study looking at new ways to spot liver cancer early (PEARL)

Cancer type:

Liver cancer





This study is looking at blood and urine samples to pick up liver cancer earlier. 

It is for people who have a type of liver disease called cirrhosis Open a glossary item. Cirrhosis is scarring of the liver due to previous damage.

The study is part of a larger research programme called DeLIVER that is looking at improving the diagnosis of liver cancer.

More about this trial

The most common type of liver cancer is called hepatocellular carcinoma (HCC). People with cirrhosis have a higher risk of developing this type of cancer. 

People with cirrhosis usually have regular ultrasound scans Open a glossary item of the liver and blood tests. This aims to try to pick up cancer in its early stages. Finding cancer early means it’s easier to treat. 

Sometimes the scans don’t detect liver cancer at an early stage Open a glossary item. So researchers are looking at new ways to do this. In this study they are looking at blood and urine samples from people who have cirrhosis. 

The aims of this study are to use the samples to work out ways to:

  • predict who is most at risk of developing HCC 
  • find liver cancer earlier than it is picked up on a routine scan 

Please note - you won’t directly benefit from taking part in this study. Taking part will not change your treatment.

Who can enter

The following bullet points are a summary of the entry conditions for this study. Talk to your doctor or the study team if you are unsure about any of these. They will be able to advise you. 

Who can take part

You may be able to join this study if all of the following apply. You:

  • have cirrhosis of the liver. Your liver is either working normally or you have mild to moderate liver damage. This is Child-Pugh A or B. Your doctor will know this. 
  • have at least one of the following conditions: a long term hepatitis B or hepatitis C infection, liver damage caused by drinking alcohol (alcoholic liver disease), a build up of fat in the liver (metabolic dysfunction-associated steatotic liver disease) or an inherited condition (haemochomatosis) where iron levels in the body slowly build up over many years
  • are at least 18 years old 

Who can’t take part

You cannot join this study if any of these apply. You:

  • have hepatocellular liver cancer or you have been diagnosed with this in the past 
  • have had a liver transplant Open a glossary item or you are on the waiting list for one
  • have severe liver damage 
  • have another medical condition that the study doctor thinks could affect you taking part or there is another reason you are not suitable for this study

Trial design

This study is taking place in the UK. The study team need 3,000 people to take part. You will be in the study for at least 3 years. 

The study team will explain the study to you. If you agree to join they ask you questions including:

  • where you were born
  • about any medical conditions you have 
  • how much alcohol you drink

They also measure your height and weight. 

The team take 3 extra blood samples in total. Where possible you have these at the same time as any routine blood tests. They also collect 3 urine samples in total. These are done:

  • when you join the study
  • at 18 months
  • at 3 years 

You have another blood and urine sample taken if you are diagnosed with HCC during the study. 

The team plan to use the samples to:

  • look for genes Open a glossary item in the blood that may indicate liver cancer 
  • try to identify genes that could increase the risk of developing HCC
  • look for antibodies Open a glossary item against cancer cells 
  • look for biomarkers Open a glossary item and proteins that might increase the risk of cancer 

The team will ask to store any remaining samples for future research. You don’t have to agree to this. You can still take part in the study. 

Long term follow up
The team look at your medical records and medical information from NHS Digital. They collect the results of tests and scans Open a glossary item and any treatment you may have had. 

They also look at other patient registries such as the cancer registries Open a glossary item

They do this for at least 10 years after you have finished taking part in the study. 

Hospital visits

There are no extra hospital visits in this study. The team collect the urine samples and take the blood samples when you attend one of your routine hospital appointments.

The team may ask you to attend 1 extra hospital visit if you develop liver cancer. 

Side effects

There are no side effects apart from some possible slight bleeding or bruising from the blood samples.


Burton on Trent
High Wycombe
Milton Keynes
Newcastle upon Tyne
Weston Super Mare

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Eleanor Barnes

Supported by

Cancer Research UK
University of Oxford

Other information

The study is part of a larger research programme called DeLIVER that is looking at improving the diagnosis of liver cancer. Other studies that are part of this programme are:

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

Rate this page:

No votes yet
Thank you!
We've recently made some changes to the site, tell us what you think