Primary liver cancer (later referred to as liver cancer) is one of the most common malignancies. Globally, there are about 780,000 new cases of primary liver cancer each year, including 550,000 men and 230,000 women, while about 730,000 patients die from liver cancer each year. The incidence of liver cancer in China is the highest in the world, and the number of new cases and deaths of liver cancer each year exceeds 50% of the global cases. Currently, the incidence rate of liver cancer in China is in the 3rd place and the mortality rate is in the 2nd place. The overall 5-year survival rate of liver cancer is less than 5%, so it is also known as the “king of cancers”. Liver cancer has become a serious threat to people’s health and lives in China. To make matters worse, the incidence of liver cancer is on the rise due to alcoholism, obesity and hepatitis infection. Screening for high-risk groups Although medicine has made great progress in recent years, greatly improving the diagnosis and treatment of liver cancer, the survival rate of liver cancer has not improved significantly. The reasons for this are: early stage liver cancer often has no clinical manifestations, and patients with middle and late stage liver cancer show symptoms such as abdominal pain and jaundice, but they often lose the chance of surgery or other treatments due to advanced tumor or poor liver function. Therefore, early diagnosis of liver cancer is of great importance and can improve the survival rate of liver cancer. The early detection of liver cancer must not be improved by simply relying on patients’ outpatient visits, because these patients often have abdominal pain and other discomforts, which is a passive process. How to achieve early diagnosis is to change passive to active, and popularizing liver cancer screening for high-risk groups is a very effective way. High-risk groups of liver cancer: Hepatitis history: people over 30 years old, HBV and HCV infected people are the high-risk groups of liver cancer. According to the latest statistics from WHO (World Health Organization), there are at least 350 million people with chronic hepatitis B (Hepatitis B) and at least 170 million people with chronic hepatitis C (Hepatitis C) worldwide. HBV is prevalent mainly in China and Africa, while HCV is prevalent mainly in Europe, America and Japan. In China, 80-90% of primary liver cancer patients are combined with hepatitis B. Hepatitis B is easily transformed into cirrhosis and then into liver cancer, but there are also a small number of patients who directly transform from hepatitis to liver cancer. The incidence rate of hepatocellular carcinoma in men is 2.5 times higher than that in women. For people with high incidence of liver cancer, AFP test and ultrasound should be performed every 3-6 months, which is an economic, easy and effective method for early detection of liver cancer. If AFP is elevated, abdominal enhancement CT or MRI should be performed. Family history of liver cancer: domestic liver cancer incidence has an obvious tendency of family aggregation, which is mainly caused by genetic mutation and exposure to common high-risk environment. Therefore, the incidence rate of liver cancer is much higher than that of the general population, especially for those who are infected with hepatitis B through vertical transmission from mother to child and have a family history of liver cancer, whose incidence rate is tens of times higher than that of the general population, and the age of onset is earlier and the healing is worse. We often see several siblings infected with hepatitis B from their mothers, and then all of them develop liver cancer at about the same age and eventually die. Therefore, people with a high incidence of this type of liver cancer should have a fetoprotein test and ultrasound every 3 months and an enhanced CT or MRI of the abdomen once a year. Normally, I always ask liver cancer patients if they have any siblings while seeing patients, and whether they have any history of hepatitis, to remind them of regular screenings. Long-term alcoholics: As we all know, drinking hurts the liver. Long-term alcoholism can cause alcoholic cirrhosis of the liver, and some of these cirrhosis can turn into liver cancer. According to the Daily Mail, a recent study by the World Cancer Research Fund found that drinking three glasses of wine a day is enough to cause liver cancer. The redness of the face is caused by the absence or mutation of acetaldehyde deoxygenase in the body, which produces a large amount of acetaldehyde that cannot be broken down and accumulates in the body, resulting in redness and tachycardia, and acetaldehyde is far more toxic to the liver than ethanol. The latest information shows that the incidence of liver cancer in these people is 3.5 times higher than that of normal people. Banna people love to drink, but not in excess, and must limit alcohol. It is recommended to check AFP and ultrasound half yearly. Non-alcoholic fatty liver disease: Non-alcoholic fatty liver mainly includes obesity, dyslipidemia, type 2 diabetes and metabolic syndrome. Currently, there are more and more patients with obesity and fatty liver at younger and younger ages. The vast majority of fatty liver patients are still unaware of:Fatty liver can also develop liver fibrosis, and patients with advanced fibrosis have a higher risk of developing liver cancer. According to statistics, the annual increase of liver cancer in fatty liver patients is about 5%, which is the most important reason for the increase of liver cancer incidence. In addition, this group of patients has a worse prognosis because of the loss of surgery and other treatment opportunities due to poor liver function often caused by fatty liver. Semi-annual AFP and ultrasound checks are recommended. Currently, screening for people at high risk for liver cancer needs to be further improved. Although guidelines have recommended that patients with cirrhosis should be monitored for hepatocarcinogenesis, less than 20% of patients with cirrhosis are monitored for HCC, according to survey data from the United States. Therefore, it is of great importance to conduct relevant scientific education, including lectures on radio and television, to make these high-risk groups conscious of regular screening themselves.