There has been controversy about the complementary use of AFP testing as a biomarker for HCC surveillance.[8,10] A stage-specific meta-analysis of 13 prospective studies found only a minimal effect of adding AFP measurement on the sensitivity of detection of early HCC.[9] However, inter-study heterogeneity in the included individuals, in the AFP cut-offs, and in the reference imaging make these findings unreliable. This evidence concerns the gene AFP and hepatocellular carcinoma.