AFP and hepatocellular carcinoma: Hepatocellular carcinoma (HCC) is the fifth most common cancer but the second leading cause of cancer-related death worldwide.[1–3] HCC has a high correlation with viral- and alcohol-related cirrhosis[4] and is the second leading cause of cancer-related death in Taiwan.[5] Performing ultrasound and monitoring alpha-fetoprotein (AFP) in patients with an elevated risk of HCC is suggested,[6–9] but only a small percentage of HCCs are diagnosed during routine monitoring.