The original EDRN case–control study of 419 US patients with HCC (208 early-stage) and 417 controls with cirrhosis found that AFP had a higher ROC AUC (0.80, 95% CI 0.77–0.84) than PIVKA-II (0.72, 95% CI 0.68–0.77), with the AUC of the combined biomarkers slightly higher than either biomarker alone (0.83, 95% CI 0.80–0.87) [17]. Here, AFP is linked to hepatocellular carcinoma.