Although biannual screening using US plus AFP has shown promise in HBV patients (Zhang et al. 2004), reducing HCC mortality in this group by 37%, its limitations are compounded by the widespread use of antiviral therapies and the rising prevalence of obesity and MASLD/MASH (Esfeh et al. 2020), for whom screening guidelines are less well-defined. Here, AFP is linked to hepatocellular carcinoma.