A meta-analysis performed in 2018 in the United States showed that AFP used alone improves detection accuracy in clinical practice for HCC at any stage and also at an early stage, albeit with a moderate decrease in specificity.9 AFP received a ‘conditional’ recommendation for use in conjunction with a 6-monthly US according to AASLD guidelines, but little is yet known about the performance of this combination or US plus other biomarkers. The gene discussed is AFP; the disease is hepatocellular carcinoma.