There is no evidence that it is beneficial to screen for hepatocellular carcinoma in symptomatic patients with HCV. (Strength of Recommendation [SOR]: C, based on a systematic review and case series studies.) Neither serum AFP measurement nor imaging is an ideal screening test. Patients can be screened for hepatocellular carcinoma using AFP measurement or ultrasonography; these tests have similar sensitivity and specificity. Computed tomography and magnetic resonance imaging offer increased screening sensitivity, but may be limited by cost and availability. (SOR: C, based on retrospective case series.) Combined testing with AFP measurement and ultrasonography improves sensitivity but decreases specificity
