What is screening?

Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.

Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.

It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.

If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.

General Information About Liver (Hepatocellular) Cancer

Liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver.

The liver is one of the largest organs in the body. It has two lobes and fills the upper right side of the abdomen inside the rib cage. Three of the many important functions of the liver are:

• To filter harmful substances from the blood so they can be passed from the body in stools and urine.
• To make bile to help digest fats from food.
• To store glycogen (sugar), which the body uses for energy.

Anatomy of the liver. The liver is in the upper abdomen near the stomach, intestines, gallbladder, and pancreas. The liver has a right lobe and a left lobe. Each lobe is divided into two sections (not shown).

See the following PDQ summaries for more information about liver (hepatocellular) cancer:

• Liver (Hepatocellular) Cancer Prevention
• Adult Primary Liver Cancer Treatment
• Childhood Liver Cancer Treatment

Liver cancer is less common in the United States than in other parts of the world.

Liver cancer is uncommon in the United States, but is the fourth most common cancer in the world. In the United States, men, especially Chinese American men, have a greater risk of developing liver cancer.

Having hepatitis or cirrhosis can increase the risk of developing liver cancer.

Anything that increases the chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for liver cancer include:

• Having hepatitis B or hepatitis C; having both hepatitis B and hepatitis C increases the risk even more.
• Having cirrhosis, which can be caused by:
  • hepatitis (especially hepatitis C); or
  • drinking large amounts of alcohol for many years or being an alcoholic.
• Eating foods tainted with aflatoxin (poison from a fungus that can grow on foods, such as grains and nuts, that have not been stored properly).

Liver (Hepatocellular) Cancer Screening

Tests are used to screen for different types of cancer when a person does not have symptoms.

Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) helps a person live longer or decreases a person’s chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.

There is no standard or routine screening test for liver cancer.

Although there are no standard or routine screening tests for liver cancer, the following tests are being used or studied to screen for it:

Ultrasound

Ultrasound is a procedure in which high-energy sound waves (ultrasound) are bounced off the liver and make echoes. The echoes form a picture of the liver called a sonogram. The picture can be printed to be looked at later.

CT scan

CT scan is a procedure that makes a series of detailed pictures of the liver, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the liver show up more clearly. This procedure is also called CAT scan or computed tomography.

Tumor markers

Tumor markers, also called biomarkers, are substances made by the tumor that may be found in the blood, other body fluids, or tissues. A high level of a specific tumor marker may mean that a certain type of cancer is present in the body.

Alpha-fetoprotein (AFP) is the most widely used tumor marker for detecting liver cancer. However, other cancers and certain conditions, including pregnancy, hepatitis, and other types of cancer, may also increase AFP levels.

Specific tumor markers that may lead to early detection of liver cancer are being studied.

Information about ongoing clinical trials is available from the NCI website.

Screening tests for liver cancer are being studied in clinical trials.

Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Risks of Liver (Hepatocellular) Cancer Screening

Screening tests have risks.

Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.

The risks of liver cancer screening include the following:

False-negative test results can occur.

Screening test results may appear to be normal even though liver cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.

False-positive test results can occur.

Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn’t) can cause anxiety and is usually followed by diagnostic tests and procedures, such as a liver biopsy, which also have risks.

Side effects may be caused by procedures to diagnose liver cancer.

Abnormal screening results may lead to a liver biopsy to diagnose liver cancer. Liver biopsy may cause the following rare, but serious, side effects:

• Hemorrhage.
• Trouble breathing.
• Leakage of bile, which can cause an infection of the lining of the abdomen.
• A small puncture (hole) in an organ in the abdomen.
• Spread of cancer cells along the needle path when the biopsy needle is inserted and withdrawn (taken out).

Your doctor can advise you about your risk for liver cancer and your need for screening tests.

About This PDQ Summary

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute’s (NCI’s) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about liver (hepatocellular) cancer screening. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary (“Updated”) is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become “standard.” Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials can be found online at NCI’s website. For more information, call the Cancer Information Service (CIS), NCI’s contact center, at 1-800-4-CANCER (1-800-422-6237).

Permission to Use This Summary

PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

The best way to cite this PDQ summary is:

PDQ® Screening and Prevention Editorial Board. PDQ Liver (Hepatocellular) Cancer Screening. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/liver/patient/liver-screening-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389386]

Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

Disclaimer

The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

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More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

Last Revised: 2019-03-22

If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI’s Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.