What is liver cancer screening?

Experts recommend that people at risk of liver cancer be tested regularly, even if they have no symptoms. Testing for a disease before there are any symptoms is called screening. People at risk of liver cancer should be screened with an ultrasound of the abdomen every 6 months, for life. A blood test for alpha-fetoprotein (AFP), which can be elevated in people with liver cancer, can also be done every 6 months in addition to the ultrasound, but it is not required.

If something concerning, such as a mass, is seen on the ultrasound, a CT or MRI scan is usually done to get more detailed views.

Who should be screened?

Screening is recommended for people at higher risk of liver cancer. To see whether this applies to you, review who is at higher risk on the Understanding liver cancer page.

What if my hepatitis C or hepatitis B was treated?

A person who develops cirrhosis due to hepatitis C is still at risk of liver cancer, even if the hepatitis C is treated successfully and the virus can no longer be detected in the bloodstream (a sustained virologic response, or SVR, has been achieved). Successful treatment of hepatitis C reduces the liver cancer risk by approximately 70%. However, the risk is not zero, so the person still needs liver cancer screening with an ultrasound every 6 months.

People with hepatitis B who are in a high-risk group should also still be screened even if their hepatitis B is being treated. Antiviral treatment of hepatitis B reduces the risk of liver cancer but does not reduce the risk to zero.

How is liver cancer diagnosed?

A diagnosis of liver cancer can often be made with radiology tests alone, without a biopsy. If a mass is seen in the liver with ultrasound, then usually either a computed tomography (CT) or magnetic resonance imaging (MRI) scan of the abdomen will be needed to look at the mass in more detail. If the mass is too small to make a diagnosis, the health care provider will often recommend repeating the CT or MRI scan every few months to watch for any changes. Sometimes a blood test reveals high levels of a substance called alpha-fetoprotein (AFP).

A biopsy of the liver, which means extracting a small sample of tissue with a hollow needle and testing it for liver cancer, is used less often. Biopsies can be difficult to perform and there are some risks involved.