Screening for liver cancer

There isn’t a national screening programme for primary liver cancer in the UK. Primary liver cancer is cancer that starts in the liver. You might have regular checks if you are at high risk of developing it. 

What is screening?

Screening means testing people for early stages of a disease. This is before they have any symptoms. For screening to be useful the tests:

  • need to be reliable at picking up cancers
  • overall must do more good than harm to people taking part
  • must be something that people are willing to do

Screening tests are not perfect and have some risks. The screening programme should also be good value for money for the NHS.

No screening available

There is no screening programme for liver cancer in the UK because:

  • it's rare so we wouldn't find many cancers
  • there's no suitable test to use for liver cancer screening
  • the cost of screening would be high

Testing for people at high risk

For any rare or uncommon cancer, it is most cost effective to screen people who are thought to be at higher risk.

There are some groups of people that doctors already know are at higher risk of hepatocellular carcinoma (HCC). HCC is the most common type of primary liver cancer.

Your doctor might recommend routine testing if you have:

  • scarring of your liver (liver cirrhosis)
  • long term (chronic) infection of hepatitis B or C infection

Your doctor will also look at factors such as your age and how much scarring (fibrosis) your liver has.

If you are at higher risk, you usually have an ultrasound scan every 6 months to check for growths in your liver. You may also have blood tests for AFP (alpha fetoprotein), which can be raised in some people with HCC.

Having these tests regularly can pick up hepatocellular cancers earlier, when they are smaller and surgery may be possible. 

Speak to your liver specialist at your next check up if you have cirrhosis and are concerned that you're not having tests. They usually suggest tests if you are well enough for treatment, should you have liver cancer.

Last reviewed: 
27 Sep 2021
Next review due: 
27 Sep 2024
  • Hepatocellular carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    A Vogel and others
    Annals of Oncology, 2018. Volume 29, Supplement 4, Pages 238-255

  • EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
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    Journal of Hepatology, 2018. Volume 69, Pages 182-236

  • AGA Clinical Practice Update on Screening and Surveillance for Hepatocellular Carcinoma in Patients With Nonalcoholic Fatty Liver Disease: Expert Review

    R Loomba and others

    Gastroenterology, 2020. Volume 158, Number 6, pages 1822-1830

  • Hepatitis B (chronic): diagnosis and management

    National Institute for Health and Care Excellence (NICE), 2013 (updated 2017)

  • Cirrhosis in over 16s: assessment and management

    National Institute for Health and Care Excellence (NICE), 2016

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