Liver cancer marker (Alpha-fetoprotein, AFP)

Alpha-fetoprotein (AFP) is a protein, which is present at low levels in the blood. It is widely recognised as a liver cancer marker as AFP levels can be elevated in the presence of a liver cancer (hepatocellular carcinoma).

Other than detecting cancer, AFP is also used to screen pregnant women for developmental abnormalities in their foetus.

Causes of an elevated AFP level:

  1. Liver cancer (hepatocellular carcinoma)
  2. Germ cell cancers of the testis and ovary
  3. Pregnancy
  4. Severe liver damage (e.g. viral hepatitis)
  5. Chronic liver infections such as hepatitis C

An elevated AFP level should never be ignored. It may indicate the presence of a cancer. The most common cancer is hepatocellular carcinoma, a liver cancer. Hence, a Gastroenterologist is often consulted for this problem.

The work-up of an individual with an abnormal AFP includes a physical examination, blood tests for liver diseases, and a detailed liver scan such as a CT or MRI. If the liver is healthy, then the reproductive organs (testis or ovaries) may need to be checked.

Dr Eric Wee,
Consultant Gastroenterologist and Hepatologist,
Nobel Gastroenterology Centre
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