National Cancer Institute
Post Date: May 17, 2022
Liver (hepatocellular) cancer screening is not currently recommended as a routine part of cancer screening. Not all screening tests are helpful, and many have risks. Learn more about liver cancer and the tests used to detect it in this expert-reviewed summary.
Liver (Hepatocellular) Cancer Screening
What Is Liver Cancer?
Primary liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. Cancer that forms in other parts of the body and spreads to the liver is not primary liver cancer. 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. The main functions of the liver include the following:
- to make bile to help digest fat that comes from food
- to store glycogen (sugar), which the body uses for energy
- to filter harmful substances from the blood so they can be passed from the body in stools and urine
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).
Types of liver cancer
Hepatocellular carcinoma and bile duct cancer (cholangiocarcinoma) are the main types of adult primary liver cancer.
Most adult primary liver cancers are hepatocellular carcinomas. This type of liver cancer is the third leading cause of cancer-related deaths worldwide.
Primary liver cancer can occur in both adults and children. However, treatment for children is different than treatment for adults. For more information, see Childhood Liver Cancer.
Signs and symptoms of liver cancer
These and other signs and symptoms may be caused by adult primary liver cancer or by other conditions. Check with your doctor if you have any of the following:
- a hard lump on the right side just below the rib cage
- discomfort in the upper abdomen on the right side
- a swollen abdomen
- pain near the right shoulder blade or in the back
- jaundice (yellowing of the skin and whites of the eyes)
- easy bruising or bleeding
- unusual tiredness or weakness
- nausea and vomiting
- loss of appetite or feelings of fullness after eating a small meal
- weight loss for no known reason
- pale, chalky bowel movements and dark urine
Liver Cancer 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.
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.
Tests to screen for liver cancer
Although there is no standard or routine screening tests for liver cancer, the following tests are being used or studied to screen for it:
Ultrasound is a procedure in which high-energy waves (ultrasound) are bounced off the liver and make echoes. The echoes form a picture of the liver called a sonogram.
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.
Alpha-fetoprotein tumor marker
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.
Doctors use these screening tests to find, or diagnose, liver cancer. Learn more about Liver Cancer Diagnosis.
Risks of liver cancer screening
Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risk of harms associated with them. Before having any screening test, you may want to discuss the test with your doctor. It is important to be aware of any possible harms of the test and whether the test 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.
- Procedures to diagnose liver cancer can cause complications. Abnormal screening results may be followed up with a liver biopsy to diagnose liver cancer. Liver biopsy may cause the following rare, but serious, complications:
- 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 where 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.