Liver Cancer Testing and Diagnosis

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Screening tests check for a condition, like cancer, in people who don’t have any signs or symptoms. There aren’t any screening tests for people who are at average risk for liver cancer. So, the best way to detect this disease as early as possible is to see your primary care provider if you have any signs or symptoms that concern you.

If you have a health condition that puts you at higher risk for liver cancer, you might have screening options. Talk with your primary care provider — or your liver specialist if you have one. They may recommend a blood test or ultrasound to check for signs of liver cancer.

Fred Hutch Cancer Center is taking part in the National Liver Cancer Screening Trial to compare methods to detect liver cancer in people with cirrhosis or chronic hepatitis B infection.

Liver Cancer Care Tailored to You

You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.

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History and Exam for Liver Cancer

If you have signs or symptoms that could be from liver cancer, your provider will ask you about your symptoms, your health history and your family history. They may ask about factors that might put you at risk for cancer or other conditions that might cause the same symptoms.

Based on your conversation and exam, your provider may order tests to get more information.

Tests for Liver Cancer

For liver cancer diagnosis, physicians may use a mix of imaging tests, blood tests and sometimes biopsies.

Imaging Tests for Liver Cancer

Imaging tests offer a way for your physician to find and look at tumors in your liver. Often, physicians can tell enough from the images to make a diagnosis of liver cancer. Imaging might include an ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI) scan.

Fred Hutch and UW Medicine physicians are working on another imaging method to detect liver tumors earlier, when they’re too small to see on a CT or MRI. The approach pairs an antibody that seeks cancer cells with a radioactive tracer. It could reveal even very tiny liver cancers on a targeted positron emission tomography (PET) scan.

Alpha-fetoprotein Tests for Liver Cancer

An alpha-fetoprotein (AFP) tumor marker test checks for a protein in your blood that may be high if you have liver cancer or another liver problem (as well as some other conditions). High AFP does not mean for certain that you have liver cancer. It’s one piece of information your care team might use to understand your liver health. If you have a condition that puts you at risk for liver cancer, like cirrhosis (scarring of the liver) or chronic hepatitis B, your physician might suggest doing AFP tests over time to help screen for cancer.

Other Blood Tests for Liver Cancer

As part of your work-up to diagnose liver cancer, you may have other blood tests too, like liver function tests to check for high levels of substances the liver releases. Your liver function is an important detail for planning your treatment if you have cancer. Liver function is also important because some treatments might not be good options for you if your liver isn’t working well.

Biopsy for Liver Cancer

In a biopsy, a physician removes a small sample of tissue from your liver. A pathologist looks at the sample under a microscope to check for cancer cells. For many cancers, physicians need to do a biopsy to make the diagnosis. That’s not usually the case for liver cancer.

Dr. Gentry King in a white physician coat
Dr. Gentry King is a medical oncologist specializing in treating gastrointestinal cancers, including liver cancer.

Why Choose Fred Hutch for Liver Cancer Care

When you choose Fred Hutch for care, our experts confirm your liver diagnosis. Liver cancer is more complex than other cancers because most people with this disease also have liver damage.

Before your first visit, your care team will review any imaging and blood tests you’ve already had and your pathology slides (tissue samples) if you had a biopsy.

During your first visit, you’ll see your physician, who will ask about your medical history and symptoms and do an exam. Then, they’ll explain what they found and what we recommend for you.

Most newly diagnosed patients have not yet had tests to stage their disease (check the extent of the disease in their body). If you haven’t had these tests yet, we will talk with you about which tests you need and why, how to get them and when you can expect results. We offer all these tests at Fred Hutch and they usually happen within a few days after your first appointment.

Liver Cancer Testing and Diagnosis FAQ

For an ultrasound, CT scan or MRI, your physician may ask you to adjust what you eat the night before or to avoid eating or drinking for a certain amount of time before the scan. It depends on the view they want to get, the type of scan and if they will be giving you a substance to help your liver show up on the scan (contrast). Otherwise, there’s usually no special prep that patients need to do.

For AFP tumor marker tests, you don’t need to do anything special. For liver function blood tests, you’ll probably need to avoid eating or drinking for several hours before the test.

Before an ultrasound, CT or MRI, you might get a substance to help your liver show up on the scan (contrast). For organs in the belly, contrast may be given by mouth or by IV.

The process and amount of time for each type of scan is different.

Blood tests for AFP tumor marker and liver function involve just a quick blood draw using a needle that goes into a vein in your arm.

There are no special risks to having an ultrasound. CT scans use radiation, but the benefits of getting a diagnosis outweigh the risks.

The magnets used in MRI scans aren’t harmful, but they might affect metal medical devices in your body.

If you are getting contrast, there is a risk of having an allergic reaction.

The main risks from blood tests are that you’ll have mild discomfort or bruising where the needle went in your arm.

The time it takes for results may depend on which tests you have. It may take from a few days to a week or more. After tests are done, the radiologist or lab will provide a report saying what they found. When you go in for your tests, ask your care team how long it will take to get results in your case.