HCC Biomarkers

AFP-L3 and DCP

Liver Cancer Surveillance is Life-Saving

Liver cancer surveillance is the application of screening tests such as blood tests and ultrasonography at regular intervals, intended to identify liver cancer at an early stage in individuals who are at risk. Robust surveillance in high risk patients is critical to finding liver cancer in its early stage which is when more effective treatment options are available and can be applied with more success. The treatment options that are available for early stage liver cancer are associated with better long term outcomes.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. We will refer to it as liver cancer throughout this page.

Are you at risk of developing liver cancer?

The risk for development of liver cancer is higher in certain patient groups, mainly hepatitis B carriers and patients with cirrhosis. Following is a more detailed list of the high risk groups for liver cancer development.

Hepatitis B carriers:

  • Individuals with family history of HCC
  • African individuals
  • Asian men over age 40
  • Asian women over age 50

Individuals with cirrhosis:

  • Patients with hepatitis B
  • Patients with hepatitis C
  • Individuals with alpha 1-antitrypsin deficiency
  • Individuals with hereditary hemochromatosis
  • Patients with stage 4 primary biliary cirrhosis
  • patients with cirrhosis of any other cause

If you belong to any of the established at risk groups no matter where you reside, ask for referral to or enrollment into a liver cancer surveillance program without further delay. Bring the flyer below and discuss with your doctor.

Liver Cancer Surveillance

Practice guidelines from the American Association for the Study of Liver Diseases (AASLD) and National Comprehensive Cancer Network (NCCN) recommend primary liver cancer surveillance by periodic screening (every 3-6 months) for patients at high-risk for liver cancer development. Collectively, evidence supports surveillance in high-risk groups. A blood test called alpha-fetoprotein (AFP) has been in use by US doctors as a surveillance tool. AFP-L3 (Lectin-reactive alpha-fetoprotein) and DCP (des-gamma-carboxy prothrombin) are in vitro diagnostic (IVD) blood tests, to be used as aids in risk assessment for development of liver cancer.

AFP-L3 and DCP blood tests:

  • Elevated values in these blood tests (DCP or AFP-L3) have been shown to be associated with an increased risk of developing liver cancer.
  • These tests were found to be safe and effective and should be used as additional tools for liver cancer risk assessment.
  • The tests are readily available at major reference laboratories.

Liver Cancer Facts

Hepatocellular carcinoma is the most common type of primary liver cancer and is the third leading cause of cancer-related death in the world. Major risk factors for liver cancer include infection with HBV and/or HCV, or alcoholic liver disease. New study data suggests that nonalcoholic fatty liver disease (NAFLD) is also a contributing risk factor. NAFLD typically results as a complication of metabolic syndrome due to obesity and diabetes.

USA statistics:

Primary liver cancer is increasing in the USA. It is estimated by the American Cancer Society that there will be 30,640 new liver cancer cases diagnosed and 21,670 deaths due to liver cancer in the United States in 2013.

World statistics:

Each year, primary liver cancer is diagnosed in more than 700,000 people worldwide, including approximately 30,000 new cases in the United States. The geographical distribution patterns of the major liver cancer risk factors worldwide are below.


Major Established Risk Factors At Risk Pupulations
Hepatitis B virus Infection Asia and Africa
Hepatitis C virus Infection United States, Europe and Japan
Alcoholic Liver Disease United States and Europe
Food contamination by Aflatoxin East Asia and Africa