The etiological factors of liver cancer in China include hepatitis virus infection, food aflatoxin contamination, long-term alcohol abuse and blue-green algae toxin contamination of rural drinking water, other liver metabolic diseases, autoimmune diseases and cryptogenic liver disease or cryptogenic cirrhosis. Since early diagnosis of liver cancer is crucial for effective treatment and long-term survival, early screening and early surveillance of liver cancer are highly emphasized. Routine surveillance screening indicators mainly include serum alpha-fetoprotein (AFP) and liver ultrasonography (US). Screening is generally performed at 6-month intervals for men ≥40 years of age or women ≥50 years of age with HBV and/or HCV infection, alcoholism, comorbid diabetes mellitus, and a family history of liver cancer in high-risk groups. It is generally believed that AFP is a relatively specific tumor marker for HCC, and persistent elevation of AFP is a risk factor for the development of HCC. Recently, some European and American scholars believe that the sensitivity and specificity of AFP is not high, and the 2010 edition of the American Association for the Study of Liver Diseases (AASLD) guidelines no longer use AFP as a screening indicator, but most of the HCC in China is associated with HBV infection, which is different from the causative factors of HCC in western countries (mostly HCV, alcohol and metabolic factors). The situation, the routine monitoring of HCC screening indicators continue to retain AFP.