Quick answer. Liver cancer (hepatocellular carcinoma, HCC) is one of the more common cancers in Singapore, especially in men, where it ranks among the top cancers. The biggest risk groups are people with chronic hepatitis B, chronic hepatitis C, or cirrhosis from any cause. Liver cancer is often silent until advanced, so doctors recommend regular surveillance for at-risk people rather than waiting for symptoms: typically a liver ultrasound, sometimes with an AFP blood test, every 6 months. Catching tumours early – when small – makes curative treatment possible. If you are a hepatitis B carrier or have cirrhosis, ask your doctor whether you should be on a surveillance programme.
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer – cancer that starts in the liver itself. Singapore has a relatively high incidence compared with many Western countries, largely because of the historical burden of chronic hepatitis B. Liver cancer ranks among the most common cancers in Singaporean men.
The key to surviving liver cancer is finding it early, while it is still small and treatable. Because it usually causes no symptoms until late, the strategy for people at high risk is regular surveillance – planned scans at fixed intervals. This guide explains who needs surveillance, how it is done, and what treatment options exist. It is general information and not a substitute for advice from your doctor or a liver specialist.
At a glance
| Question | Answer | Notes |
|---|---|---|
| Who is at high risk? | Chronic hepatitis B or C carriers; anyone with cirrhosis | Risk is higher with family history of liver cancer |
| What is surveillance? | Liver ultrasound, sometimes with an AFP blood test | Done at planned intervals, not just when unwell |
| How often? | About every 6 months | Lifelong for most high-risk groups |
| Why bother if I feel well? | HCC is usually silent until advanced | Early detection allows curative treatment |
| If something is found | Further imaging (CT or MRI) to confirm | Small early tumours have many treatment options |
| Treatment options | Surgery, ablation, transplant, embolisation, drug therapy | Depends on tumour size, number and liver function |
Why liver cancer matters in Singapore
Liver cancer is one of the more common cancers in Singapore and is consistently among the leading cancers in men, with a clear male predominance. The main reason is the historical prevalence of chronic hepatitis B, which is the dominant risk factor locally. Chronic hepatitis C, alcohol, and increasingly fatty liver disease (MASLD) also contribute.
Although vaccination has reduced hepatitis B in younger Singaporeans, many older residents are long-standing carriers and remain at elevated risk. This is why structured liver cancer surveillance for at-risk groups is an important part of liver care in Singapore.
Who should be on a surveillance programme
Surveillance is recommended for people at high risk of liver cancer, including:
- Chronic hepatitis B carriers – the risk of liver cancer is many times higher than in non-carriers, and surveillance is recommended even without cirrhosis for many carriers (your specialist will assess your individual risk).
- Chronic hepatitis C carriers, particularly those with significant fibrosis or cirrhosis – and even after a cure if cirrhosis was present.
- Anyone with cirrhosis, whatever the cause (hepatitis, alcohol or fatty liver disease).
- People with a family history of liver cancer, who may be at additional risk.
If you fall into any of these groups, ask your doctor whether you should be enrolled in regular surveillance.
How surveillance works
The standard approach is a liver ultrasound, with or without an alpha-fetoprotein (AFP) blood test, about every 6 months. Ultrasound is safe, painless and involves no radiation. AFP is a tumour marker that can be raised in some liver cancers; used together with ultrasound, it improves the chance of picking up a tumour, though neither test is perfect on its own.
The 6-monthly interval is chosen because liver tumours can grow over months, and this frequency aims to catch them while still small. If the ultrasound is clear, you simply continue routine 6-monthly scans. If a suspicious area is found, you move on to confirmatory tests.
What happens if something is found
If surveillance picks up a liver nodule, your doctor will arrange further imaging, usually a CT or MRI scan with contrast, which can often diagnose liver cancer based on its characteristic appearance. Occasionally a biopsy is needed. A raised or rising AFP may also prompt closer evaluation.
The big advantage of surveillance is that tumours found this way are typically small and early, when the widest range of treatments – including potentially curative ones – is available. Liver cancer found only after symptoms appear is usually more advanced and harder to treat.
Treatment overview
Treatment for liver cancer depends on the size and number of tumours, whether it has spread, and how well the underlying liver is working. Options include:
- Surgical removal (resection) – for suitable early tumours in a liver that still functions well.
- Liver transplantation – can treat both the cancer and the underlying cirrhosis in selected patients.
- Ablation – destroying small tumours with heat (radiofrequency or microwave).
- Transarterial therapies – such as embolisation, which blocks the tumour’s blood supply.
- Systemic therapy – targeted drugs and immunotherapy for more advanced disease.
In Singapore, liver cancer is managed at centres such as the National Cancer Institutes and major hospitals by multidisciplinary teams. Early detection through surveillance is what makes the curative options possible.
When to see a doctor
If you are a hepatitis B or C carrier, or have cirrhosis, and are not currently in a surveillance programme, see your doctor to discuss enrolling – do not wait for symptoms. Keep your 6-monthly appointments even when you feel completely well.
See a doctor promptly if you develop persistent upper abdominal pain or a lump, unexplained weight loss, loss of appetite, or worsening tiredness. Seek urgent care for jaundice (yellow eyes or skin), severe abdominal pain or swelling, vomiting blood, or confusion – these may indicate advanced liver disease.
Related guides
- Best Gastroenterology Clinics in Singapore — our editorial shortlist
- gastroenterology clinics directory
- Hepatitis B
- Hepatitis C
- Liver cirrhosis
Sources
- National University Cancer Institute, Singapore (NCIS)
- SingHealth – Hepatitis B: Conditions & Treatments
- HealthHub – Hepatitis B
- Communicable Diseases Agency (CDA) – Hepatitis B
Related conditions & guides
Related conditions and guides you may find useful:
- Breast Cancer Screening in Singapore
- Cancer Screening in Singapore
- Cancer Treatment Cost in Singapore
- Cancer Warning Signs and Symptoms
- Colorectal (Bowel) Cancer in Singapore
- Fatty Liver Disease in Singapore
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