How is Liver Cancer Detected: What You Need to Know

In 2022, the World Health Organization (WHO) reported that liver cancer was the third deadliest cancer worldwide. In the United States alone, it’s estimated that about 42,240 new cases will be diagnosed in 2025. Hepatocellular carcinoma is the most common form of liver cancer, and accounts for ~90% of cases.

As liver cancer symptoms often appear only in later stages, regular screening is crucial, especially for those at higher risk. This article highlights why early detection matters and provides an overview of the key tests used to detect liver cancer.

Detecting liver cancer early means having access to more treatment options and better chances of survival. Catching it early can also help minimize other health complications caused by cancer. These are the reasons why early detection of cancer is important.

Liver cancer is often severe because it usually has no symptoms in its early stages. Even when mild symptoms appear, like bloating or loss of appetite, they are easy to miss. Most cases are diagnosed only when symptoms persist and become chronic. By then, the cancer may have already spread and become more difficult to treat.

Learn more: Liver Cancer Symptoms

Liver cancer is more common in certain groups of people, such as those with liver disease or a history of cancer. It is almost always caused by long-term liver damage from various conditions, leading to scarring (cirrhosis) and affecting liver function.

Routine screening for liver cancer is vital to detect it early and is recommended for individuals who are at high risk.

Key risk factors include:

• Hepatitis B
• Hepatitis C
• Liver cirrhosis

Other risk factors include excessive alcohol consumption, fatty liver diseases, diabetes and exposure to certain environmental toxins. These factors further increase the likelihood of liver cancer.

Learn more:

Liver Cancer Screening for High-Risk Individuals

Cirrhosis and Primary Liver Cancer: How Chronic Liver Damage Increases Cancer Risk

Chronic Viral Hepatitis and Liver Cancer: From Infection to Cancer

Imaging tests are key to detecting and diagnosing liver cancer. Accurate imaging is also important for staging and planning treatment strategies for liver cancer.

These are the commonly used imaging tools for detecting and diagnosing liver cancer:

• Abdominal ultrasound
• CT (computer tomography)
• MRI (magnetic resonance imaging)

An abdominal ultrasound is usually used for regular liver cancer screening to detect suspicious lesions. If found, the test is followed by a contrast-enhanced CT or MRI for diagnosis of liver cancer. However, ultrasound screening may be less sensitive in detecting smaller liver tumors. A fatty liver may also limit its sensitivity. To address these limitations, several alternative screening tests are being actively studied, including simplified CT or MRI.

Learn more: Imaging Tests for Liver Cancer Diagnosis

Throughout the cancer journey, blood tests play vital roles in assessing liver health, diagnosing liver cancer, guiding treatment and monitoring cancer progression.

Among them, alpha-fetoprotein (AFP) is a key marker. When combined with imaging tests like ultrasound, AFP can help detect liver cancer. However, AFP alone is not always reliable.

Liver cancer is a unique cancer type — it can be diagnosed by imaging such as contrast-enhanced CT or MRI, without a tumor biopsy. However, if the imaging tests are not conclusive, a tumor biopsy would still be needed to confirm the histological diagnosis of liver cancer.

The biopsy results are recorded in a histopathology report. This report provides information about the biological aggressiveness of the tumor.