Answers
Who needs screening for liver cancer, and how is it done?
Short answer
People with cirrhosis from any cause, and some people with hepatitis B even without cirrhosis, have a higher chance of liver cancer (hepatocellular carcinoma, HCC). Screening with an ultrasound every six months, often with an AFP blood test, finds cancer early, when it can still be treated well.
Who should be screened
Your doctor will tell you whether you need screening, based on your liver condition.
- Everyone with cirrhosis, whatever the cause: alcohol, fatty liver, hepatitis B or C, or others
- People with hepatitis B with a family history of liver cancer, or other high-risk features, even without cirrhosis
- People whose hepatitis C was cured after they already had cirrhosis, as the risk does not disappear
How it is done
An ultrasound of the liver every six months, often with an AFP (alpha-fetoprotein) blood test. If something is seen, a special CT or MRI scan with contrast is done to confirm what it is.
Why early detection matters
Liver cancer usually causes no symptoms until it is advanced. When found early, it can often be treated with surgery, ablation (destroying the tumour with heat), or liver transplant, with a good chance of cure. Late cancers have far fewer options.
Lowering the risk
- Stop alcohol completely
- Treat hepatitis B and C, and take medicines regularly
- Get vaccinated against hepatitis B
- Control weight, diabetes and fatty liver
- Do not miss screening appointments, even if you feel well
Food that lowers liver cancer risk
Eat more
- Vegetables, fruits, dal and whole grains to keep weight and blood sugar in control
- Plain coffee, if you like it, is linked to a lower risk of liver cancer
- Grains, nuts and groundnuts stored dry and used fresh
Cut down
- Alcohol, completely
- Mouldy or discoloured groundnuts, maize and grains, which can contain aflatoxin, a liver cancer toxin
- Sugar, sweets, cold drinks and fried snacks that worsen fatty liver
Good to know
- No food or supplement replaces six-monthly ultrasound screening.
- Throw away nuts or grains that look mouldy or taste bitter.
Common questions
How often should I be screened?
Every six months, with an ultrasound and often an AFP blood test. Shorter gaps are not more useful; longer gaps can miss early cancers.
Is a normal AFP enough to rule out cancer?
No. Many early liver cancers have a normal AFP, which is why the ultrasound is the main test.
My hepatitis C was cured. Do I still need screening?
If you had cirrhosis before cure, yes. The risk falls but does not disappear, so screening continues.