Liver (Hepatocellular) Cancer Screening (PDQ®)

Last modified: 2013-06-07
Last downloaded: 2013-09-02

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.


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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 four 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 four lobes. Two lobes are on the front and two small lobes (not shown) are on the back of the liver.

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

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 a close relative with both hepatitis and liver cancer.
  • Having cirrhosis , which can be caused by:
    • Hepatitis (especially hepatitis C).
    • Drinking large amounts of alcohol for many years or being an alcoholic.
  • Eating foods tainted with aflatoxin (poison from a fungus than can grow on foods, such as grains and nuts, that have not been stored properly).

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Liver (Hepatocellular) Cancer Screening

Tests are used to screen for different types of cancer.

Some screening tests are used because they have been shown to be helpful both in finding cancers early and in decreasing the chance of dying from these cancers. Other tests are used because they have been shown to find cancer in some people; however, it has not been proven in clinical trials that use of these tests will decrease the risk of dying from cancer.

Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) 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.

Clinical trials that study cancer screening methods are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site.

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 Web site.


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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.


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Changes to This Summary (06/07/2013)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Images were added to this summary.


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Back to TopSource: The National Cancer Institute's Physician Data Query (PDQ®) Cancer Information Summaries (http://www.cancer.gov/cancertopics/pdq)