AFP and neoplasm: The diagnostic performance of existing tumor biomarker tests is relatively low when screening for HCC, with a sensitivity (SEN) of 0.478 (95% CI [0.447–0.509]) and a specificity (SPE) of 0.840 (95% CI [0.809–0.867]) (Zhang et al., 2020b) for AFP assay, and imaging technology typically only detect tumors that are greater than one cm in diameter (Maluccio & Covey, 2012).