In the multivariate model, adjusted for age and sex, both PIVKA-II (HR 1.05; 95% CI 1.00–1.10; p = 0.015) and AFP (HR 1.11; 95% CI 1.03–1.20; p = 0.006) remained independent predictors of HCC, indicating that each unit increase in PIVKA-II and AFP was associated with a 5% and 11% increase in HCC risk, respectively. Here, AFP is linked to hepatocellular carcinoma.