The higher the viral load and longer the duration of chronic hepatitis B patients, the greater the risk of liver cancer; studies have confirmed that the incidence of liver cancer can be greatly reduced when viral replication is effectively suppressed. The study also showed that people with a family history of liver cancer have a much higher risk of developing liver cancer than those without a family history of liver cancer. There have been many reports of family clustering of hepatocellular carcinoma in East Asia, where hepatitis B virus infection is prevalent. It has been found that a family history of hepatocellular carcinoma increases the risk of hepatocellular carcinoma and is a risk factor independent of hepatitis; the risk of hepatocellular carcinoma can be increased more than 70-fold if there is both a family history of hepatocellular carcinoma and positive serum markers of hepatitis B virus. Therefore, family history of hepatocellular carcinoma in hepatitis B patients must be given high priority, and more vigorous treatment measures must be taken for this group of cases.