Cancer screening exams can help find liver cancer at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.

Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose liver cancer early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

Liver cancer can be hard to detect because symptoms do not often appear until the cancer has progressed. There are currently no recommended screening tests for liver cancer for people who are at low risk for the disease.

For people with risk factors such as cirrhosis of the liver or a hepatitis infection, screening tests may be done once or twice a year to try to catch any early signs of cancer.

Risk Factors for Liver Cancer

A risk factor is anything that increases your chance of getting liver cancer.

Infection with the hepatitis virus and cirrhosis of the liver are two major risk factors for the disease.

Hepatitis B or C Infection

Long-term infection of the hepatitis B or hepatitis C virus is a major risk factor for liver cancer. In the United States, hepatitis B is seen more often than hepatitis C.

Hepatitis is spread through human contact. Having hepatitis B and hepatitis C is a significant risk factor for liver cancer. Most people recover from hepatitis infection but some can become chronic carriers and are at an increased risk to develop cirrhosis of the liver.


Cirrhosis is a disease of the liver that develops over time. Cells in the liver can become damaged from chronic hepatitis C infection or by drinking too much alcohol over many years. Scar tissue forms where the liver cells are damaged. Most people who develop cirrhosis will have an increased lifetime risk for liver cancer.

The following are additional risk factors for adult primary liver cancer:

  • Having a close relative with both hepatitis and liver cancer
  • Eating foods tainted with aflatoxin (poison from a fungus that can grow on foods, such as grains and nuts, that have not been stored properly)
  • Having hemochromatosis, a condition in which the body takes up and stores more iron than it needs. The extra iron is stored in the liver, heart and pancreas

(Source: National Cancer Institute)

Having risk factors does not necessarily mean you will develop liver cancer. If you do have risk factors, or a family history of the disease, ask your doctor about available tests to detect liver cancer early.

Diagnosing Liver Cancer

One or more of the following tests may be given to detect and diagnose liver cancer:

Imaging Tests

Imaging tests produce pictures of the inside of the body. There are several imaging tests that might be performed in people with liver cancer. Imaging tests can help determine the extent, or stage, of the disease. Tests may include one of the following:

Computed Tomography Scan (CT Scan)

A type of X-ray test that produces detailed, cross-sectional images of your body.

Magnetic Resonance Imaging Scan (MRI Scan)

MRI scans use radio waves and strong magnets instead of X-rays. MRI scans are helpful when the doctor needs to see the entire body. If detailed pictures of the blood vessels in and near the liver are needed, a specialized type of MRI scan called a magnetic resonance angiography may be used.


A test that uses sound waves and echoes to make a picture of internal organs or masses. Ultrasound can be used to look at lymph nodes near the surface of the body or to look for enlarged organs inside your abdomen such as the kidneys, liver and spleen.

Blood Tests

Blood tests may be taken to analyze certain proteins that can help doctors diagnose liver cancer and determine the best treatments. These tests include:

Liver Function Tests

A series of blood tests can measure certain proteins or other substances released into the blood to determine if liver cancer is present.

Tumor Biomarkers Test

Tumors produce unique proteins, or biomarkers, that they can make their way into blood or tissue. The amount present may indicate the presence of a certain type of tumor in the body.

Alpha-fetoprotein (AFP) is a biomarker used to detect liver cancer. An increase in the level of AFP can mean the cancer is present. Other factors, such as a hepatitis infection, can influence AFP levels, so other tests are often used in combination. This test can help doctors figure out what type of treatment to use and to tell if the treatment is working.


A biopsy is a procedure that removes a small piece of tissue for analysis under a microscope. There are different methods used to obtain a liver tissue sample. A biopsy is not necessary to diagnose liver cancer but it can confirm a diagnosis and help determine what type of liver cancer it is.

(Source: National Cancer Institute)

Staging Liver Cancer

There are several staging systems for liver cancer. The Barcelona Clinic Liver Cancer (BCLC) Staging System is one of the staging systems that take the function of the liver into account.

The BCLC staging system has five stages:

1. Stage 0: Very early
2. Stage A: Early
3. Stage B: Intermediate
4. Stage C: Advanced
5. Stage D: End-stage

The following groups are used to plan treatment:

BCLC Stages 0, A and B

Treatment to cure the cancer is given for BCLC stages 0, A, and B.

BCLC Stages C and D

Treatment to relieve the symptoms caused by liver cancer and improve the patient's quality of life is given for BCLC stages C and D. Treatments for liver cancer in these stages are not likely to cure the cancer.

(Source: National Cancer Institute)

If you have received a liver cancer diagnosis, or if you want a second opinion or just want to speak to a liver cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

460 West 10th Avenue

Columbus, Ohio 43210

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