AFP Tumour Marker Test

AFP is used to detect certain cancers of the liver and testis. If a patient is diagnosed with one of these types of cancer, they will then undergo periodic testing for AFP initially to monitor their response to treatment, usually followed by long-term monitoring to detect any recurrence of the cancer. In one type of testicular tumour (known as a germ cell tumour), as well as helping the diagnosis, AFP & HCG measurements are also mandatory in post-treatment monitoring following guidelines that depend on the stage of the tumour and treatment.
If you have chronic hepatitis or cirrhosis of the liver, your doctor may request AFP tests to detect hepatocellular carcinoma (a type of liver cancer) which may follow in the future.

(Please note that AFP is also used in pregnant women to assess the risk of their baby having Down's syndrome – in this case it is NOT being used to test for cancer -see AFP/maternal testing).

Your doctor or a healthcare professional will request an AFP blood test if:

• liver cancer or certain cancers of the testis are suspected
• if you are under treatment for these cancers
• if you have previously been treated for one of these cancers
• if you have chronic hepatitis or cirrhosis of the liver.

Increased AFP can be caused by liver cancer, germ cell tumour of the testis or less commonly other cancers (for example ovary, stomach, bowel, lung, breast, lymphoma). Slightly increased levels of AFP are common in patients who have chronic hepatitis or cirrhosis and do not indicate the presence of cancer.

In general, the higher the AFP result in patients with cancer, the bigger the tumour or spread if there are liver secondaries.  AFP decreases when your body responds to anti-cancer therapy. If AFP does not return to normal within about one month after cancer therapy, some of the tumour may still be present.

An increase in AFP after remission suggests recurrence of the tumour. However, tumours originally producing AFP may recur without an increase in AFP concentration.

This cancer usually occurs in people who have chronic scarring of the liver, called cirrhosis. Most commonly, this is caused by chronic infection from one of two viruses: hepatitis B and hepatitis C. Alcohol abuse also increases the risk of developing cirrhosis.  Some inherited diseases, especially a disorder called haemochromatosis (in which the body absorbs and stores too much iron), which can cause cirrhosis and later hepatocellular carcinoma.