Tests for liver cancer

You usually have a number of tests to check for liver cancer. Liver cancer is also called hepatocellular carcinoma.

The tests you might have include:

  • blood tests

  • scans such as an ultrasound and CT scan

Most people with liver cancer are diagnosed after they become unwell and go to A&E. Others start by seeing their GP if they have symptoms that could be due to cancer.

Tests you might have to find out the cause of your symptoms

The tests you have first depend on the symptoms you have. You usually have:

  • a physical examination

  • blood tests

  • ultrasound scan

  • CT scan

  • MRI scan

You may also have a liver biopsy. This means taking a sample of liver tissue and looking at it under a microscope to look for cancer cells. Not everyone needs a liver biopsy. Doctors can often diagnose liver cancer just by looking at the scans.  

Physical examination

Your doctor feels your tummy (abdomen) for any areas that might be swollen or might not feel normal, including a lump. And if you have any pain, they will feel those areas. They may also listen to your abdomen and chest to find out if they sound normal.

Blood tests

Blood tests can check your general health including:

  • how well your liver and kidneys are working

  • check the number of blood cells such as red blood cells

Ultrasound scan of the liver

Ultrasound scans use high frequency sound waves to create a picture of a part of your body. The ultrasound can show changes in the liver, including abnormal growths.

You usually have them in the hospital x-ray department.

People who are at high risk of developing liver cancer usually have an ultrasound scan of the liver every 6 months. This is usually for people who have scarring of the liver due to previous damage (liver cirrhosis).

Speak to your GP if you think you are at risk of developing liver cancer.

CT scan

A CT scan uses x-rays and a computer to create detailed pictures of the inside of your body. The computer puts them together to make a 3 dimensional (3D) image.

You might have a CT scan of your abdomen and chest to look for any abnormal areas in your liver or elsewhere in the body.

MRI scan

MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body.

You might have an MRI scan of your abdomen to find out whether there is cancer in your liver, and if so where it is.

An MRI scan can also give your doctor information about the size of the cancer and whether it has spread to any other parts of your body.

Liver biopsy

Doctors can often diagnose liver cancer by looking at the scans. But some people also need to have a liver biopsy. Your doctor can tell you whether you need to have a biopsy or not.

There are different ways to have a biopsy of the liver. The most common way is by passing a needle through the skin into the liver.

You may also have a liver biopsy during an operation to look inside your abdomen. This is called laparoscopy or keyhole surgery. A laparoscopy can also help your doctor decide if surgery to remove the cancer is possible.

You have a laparoscopy under general anaesthetic. This means you are asleep and won’t feel anything.

Tumour markers

Tumour markers are substances that are produced by the cancer or other cells in response to cancer or other conditions. They’re usually proteins that can be found in the blood, urine or body tissues.

Some tumour markers are only produced by one type of cancer. Others can be made by several types.

Doctors might use tumour markers to monitor how well your cancer treatment is working or check if the cancer has come back.

Some people with liver cancer have high levels of a protein called alpha fetoprotein (AFP). AFP can be a tumour marker for liver cancer but the level can also be raised in people with cirrhosis who do not have cancer.

Your doctor may check the levels of AFP before and after treatment for liver cancer. This may give doctors an idea of how well treatment is working.


The tests you have help your doctor find out if you have liver cancer and how far it has grown. This is the stage of the cancer.

This is important because doctors recommend your treatment according to the stage of the cancer.

Coping with liver cancer

Coping with a diagnosis of liver cancer can be difficult. There is help and support available to you and your family.

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    A Vogel and others
    Annals of Oncology, 2018. Vol 29, supplement 4. Pages iv238-iv255

  • Hepatocellular carcinoma
    BMJ Best Practice, Last updated October 2023

  • Clinical features and diagnoses of hepatocellular carcinoma
    UpToDate, Last updated December 2022

  • Routes to Diagnosis, 2018
    NHS Digital. Published March 2022

  • Cirrhosis in over 16s: assessment and management
    National Institute for Health and Care Excellence (NICE), 2016. Last updated September 2023

  • Serum tumor markers for detection of hepatocellular carcinoma
    L Zhou, J Liu and F Luo
    World Journal of Gastroenterology, 2006. Vol 12, Issue 8. Pages 1175-1181

Last reviewed: 
01 Nov 2023
Next review due: 
01 Nov 2026

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