Also Known As
Total AFP
Formal Name
Alpha-fetoprotein, Total
This article was last reviewed on
This article waslast modified on 17 March 2021.
At a Glance
Why Get Tested?

To screen for and monitor therapy for certain cancers of the liver and testes

When To Get Tested?

If your doctor suspects that you have certain cancers of the liver or testes, if you are under treatment for them, or have previously been treated for one of these cancers. It may also be used if chronic hepatitis or cirrhosis of the liver is suspected.

Sample Required?

A blood sample taken from a vein in the arm

Test Preparation Needed?


On average it takes 7 working days for the blood test results to come back from the hospital, depending on the exact tests requested. Some specialist test results may take longer, if samples have to be sent to a reference (specialist) laboratory. The X-ray & scan results may take longer. If you are registered to use the online services of your local practice, you may be able to access your results online. Your GP practice will be able to provide specific details.

If the doctor wants to see you about the result(s), you will be offered an appointment. If you are concerned about your test results, you will need to arrange an appointment with your doctor so that all relevant information including age, ethnicity, health history, signs and symptoms, laboratory and other procedures (radiology, endoscopy, etc.), can be considered.

Lab Tests Online-UK is an educational website designed to provide patients and carers with information on laboratory tests used in medical care. We are not a laboratory and are unable to comment on an individual's health and treatment.

Reference ranges are dependent on many factors, including patient age, sex, sample population, and test method, and numeric test results can have different meanings in different laboratories.

For these reasons, you will not find reference ranges for the majority of tests described on this web site. The lab report containing your test results should include the relevant reference range for your test(s). Please consult your doctor or the laboratory that performed the test(s) to obtain the reference range if you do not have the lab report.

For more information on reference ranges, please read Reference Ranges and What They Mean.

What is being tested?

AFP is a protein that is normally produced by the developing foetus. However, AFP can also be produced by certain tumours and diseases of the liver. Raised concentrations of AFP are found in the majority of patients with a type of liver cancer called hepatocellular carcinoma and also in some patients with cancer of the testis.

Accordion Title
Common Questions
  • How is it used?

    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).

  • When is it requested?

    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.
  • What does the test result mean?

    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.

  • Is there anything else I should know?

    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.

  • What are the risk factors for hepatocellular carcinoma?

    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.

  • If my AFP is normal/abnormal, do I need other tests?

    If you have chronic liver infection or damage, a high AFP could simply be due to the disease itself.  If your AFP concentration suddenly rises, or if it is very elevated, your doctor will usually ask for a study to look at your liver, such as an ultrasound CT scan or an MRI scan.  These scans can often spot liver cancers if they are present.  A normal AFP result cannot be used to exclude a diagnosis of liver or testicular cancer.

On This Site
Tests: CEA; hCG; Tumour markers
Conditions: Liver cancer, Testicular cancer

Elsewhere On The Web
ACB, Analyte Monographs: Alpha-fetoprotein
Macmillan Cancer Support