Hepatocellular carcinoma (HCC) is the most common liver cancer, mostly affecting people with cirrhosis. Regular ultrasound screening every six months can detect tumors early, improving survival from under 20% to over 70%. Learn the latest guidelines, treatments, and why many patients still miss screening.
Liver Cancer Screening: What You Need to Know About Early Detection and Risk Factors
When it comes to liver cancer screening, a process used to find liver cancer before symptoms appear, often in people with chronic liver disease. Also known as hepatocellular carcinoma surveillance, it’s not for everyone—but if you have cirrhosis, hepatitis B, or long-term alcohol use, it could save your life. Most liver cancers don’t cause symptoms until they’re advanced. By then, treatment options are limited. Screening catches tumors early, when surgery, ablation, or even transplant still have a real chance of working.
Screening usually means two things: an ultrasound every six months and a blood test for alpha-fetoprotein, a protein that can rise when liver cancer is present. It’s not perfect—some cancers don’t raise the marker, and some non-cancer conditions can spike it—but together, they’re the best tools we have right now. People with cirrhosis, scarring of the liver from alcohol, hepatitis, or fatty liver disease. Also known as liver fibrosis, it’s the biggest risk factor for liver cancer are told to get screened regularly. Same goes for those with chronic hepatitis B, a viral infection that can live in the liver for decades, slowly damaging it and increasing cancer risk. Also known as HBV, it’s one of the leading causes of liver cancer worldwide. If you’ve had it for more than 20 years, even if your virus is under control, you’re still at risk.
Screening doesn’t mean you have cancer. It means you’re being smart. Many people avoid it because they’re scared of what they might find. But the truth is, finding a small tumor early gives you options. Waiting until you feel pain, lose weight, or turn yellow means it’s probably too late. The goal isn’t to panic—it’s to stay ahead. You don’t need a specialist to start screening. Your primary doctor can order the ultrasound and blood test. You just need to ask.
If you’re on long-term medication for hepatitis, have fatty liver from obesity or diabetes, or have a family history of liver cancer, talk to your doctor about whether screening is right for you. It’s not a one-size-fits-all rule, but for high-risk groups, skipping it is like ignoring a smoke alarm. The posts below cover what happens after screening, how treatments like ablation and targeted drugs work, and how drugs like milk thistle or NSAIDs might interact with liver health. You’ll also find real advice on managing cirrhosis, understanding blood markers, and avoiding mistakes that could make things worse. This isn’t theory—it’s what people living with liver disease need to know to protect themselves.