Liver cancer is the seventh most common cancer worldwide, and the sixth leading cause of cancer-related mortality in the United States.1,2 Hepatocellular carcinoma (HCC), the most common histologic type of liver cancer, occurs most commonly in patients with cirrhosis. However, it can occur in the absence of cirrhosis, as is well-described in patients with chronic hepatitis B. There are multiple options for screening and early detection, including serial examination with liver ultrasound and/or serum α-fetoprotein (AFP).