Other GALAD studies give figures of > 0.87 for AUROC of AFP-based all-stage HCC detection, while we observe AUC < 0.65.7–13 These differences might be explained by the high frequency of early-stage HCC cases in our cohort, low rates of HCV-associated HCC, balanced control groups with similar frequencies of cirrhosis, and population genetics. Here, AFP is linked to Cirrhosis.