Which tumor marker is most commonly used to screen for hepatocellular carcinoma?

• A. Alpha-fetoprotein (AFP)
• B. Hepatitis B surface antigen (HBsAg)
• C. C-reactive protein (CRP)
• D. Beta-human chorionic gonadotropin (β-hCG)

Answer: (A)

Alpha-fetoprotein (AFP) is the tumor marker most closely linked to hepatocellular carcinoma. AFP is produced by fetal liver cells, and some hepatocellular carcinomas continue to secrete it, so elevated AFP levels have long been used to screen and monitor HCC, especially in people with high-risk conditions like cirrhosis or chronic hepatitis B or C. In practice, AFP is used in conjunction with imaging, because no single test is perfect, but AFP specifically reflects tumor activity in the liver.

The other options aren’t tumor markers for this cancer: hepatitis B surface antigen indicates infection with hepatitis B and associated risk, not a tumor marker; C-reactive protein is a nonspecific marker of inflammation; beta-hCG is a pregnancy hormone also elevated in some germ cell tumors, not hepatocellular carcinoma.