Liver Cancer Diagnosis: Tests for Hepatocellular Carcinoma
Diagnosing hepatocellular carcinoma usually combines blood tests and imaging. In people with cirrhosis, a confident diagnosis can often be made from imaging alone because HCC has characteristic features; in other cases a biopsy may be needed.
Blood Tests
- Alpha-fetoprotein (AFP) — a tumor marker that is elevated in many people with HCC and can support diagnosis and monitoring.
- Liver function tests — measure how well the liver is working and help assess overall liver health.
- Viral hepatitis testing — to identify underlying hepatitis B or C.
Imaging
- Ultrasound — the main tool for routine surveillance in at-risk patients.
- Multiphase CT and MRI — detailed scans that can identify HCC by its characteristic blood-flow pattern, often reported using the LI-RADS system.
Biopsy
A liver biopsy — removing a small tissue sample for examination — is used when imaging is not conclusive. It can confirm the diagnosis and provide details about the tumor's grade and type.
Surveillance for Early Detection
People with cirrhosis or chronic hepatitis B are generally advised to have an ultrasound (sometimes with AFP) about every six months, so that tumors can be found at an early, more treatable stage.
This page is for general education and is not medical advice. A physician can determine which tests are appropriate for you.
Frequently Asked Questions
How is hepatocellular carcinoma diagnosed?
Diagnosis often involves imaging tests such as ultrasound, CT, or MRI, along with blood tests including the alpha-fetoprotein (AFP) marker. In some cases a biopsy is used to confirm the diagnosis. Your doctor will determine the right tests for you.
What is the AFP blood test?
Alpha-fetoprotein (AFP) is a substance that can be elevated in some people with liver cancer. It is one tool doctors use, alongside imaging, to help evaluate the liver.
What are the symptoms of liver cancer?
Early liver cancer often causes no symptoms. Later signs can include abdominal pain or swelling, unexplained weight loss, loss of appetite, fatigue, and jaundice (yellowing of the skin or eyes). See a doctor if you have concerns.
When should I see a doctor?
If you have risk factors for liver disease or symptoms that concern you, talk to your doctor. Earlier evaluation gives the best chance to find any problems sooner.