People with cirrhosis are at increased risk of developing liver cancer. The cirrhosis may be due to hepatitis C virus, hepatitis B virus, alcohol, fatty liver, or other causes. People living with hepatitis B are also at risk of liver cancer even if they haven't developed cirrhosis, especially if they have a high hepatitis B viral load or are of Asian or African descent. Among patients living in the United States with both hepatitis C and cirrhosis, about 1-4% per year will develop liver cancer.

What is liver cancer screening?

Experts recommend that persons at risk of liver cancer be tested regularly, even if they have no symptoms. Testing for the presence of a disease before there are any symptoms is called screening. People at risk of liver cancer must be screened with an ultrasound of the abdomen, every 6 months, for life. A blood test for alpha-fetoprotein (AFP), which can be elevated in persons with liver cancer, can also be done every 6 months, in addition to the ultrasound.

What about hepatitis C patients who have been successfully treated?

A person who develops cirrhosis due to hepatitis C is still at risk of liver cancer, even if the hepatitis C is treated successfully and the virus can no longer be detected in the bloodstream (blood tests show a sustained virologic response, or SVR, has been achieved). Successful treatment of hepatitis C reduces the liver cancer risk by approximately 70%. However, the risk is not zero. Therefore, the person will still need liver cancer screening.

Who should be screened for liver cancer?

• anyone with cirrhosis, due to any underlying cause (hepatitis B, hepatitis C, alcohol, hemochromatosis, fatty liver, etc.)
• anyone infected with the hepatitis B virus who has a family history of liver cancer
• Asian men with hepatitis B, over age 40
• Asian women with hepatitis B, over age 50
• African and/or North American blacks with hepatitis B