The current gold-standard and only established noninvasive diagnostic marker for HCC is serum AFP, but this fails in diagnostic performance ability, making it unreliable.30 The American Association for the Study of Liver Diseases (AASLD) describes the relationship of AFP to HCC as lacking “adequate sensitivity and specificity for effective surveillance and diagnosis”.10 Serum AFP level and 6-monthly ultrasound (US) scans are used for surveillance and diagnosis of HCC.5 However, these are often unsuitable for resource-limited settings as imaging is often expensive or unavailable. Here, AFP is linked to hepatocellular carcinoma.