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AFP tumour marker

Also known as: AFP; alpha-fetoprotein
Related tests: CEA, hCG, tumour markers

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, have previously been treated for one of these cancers, or are under treatment for them, or if you have chronic hepatitis or cirrhosis

Sample Required?

A blood sample drawn from a vein in the arm

The Test Sample

What is being tested?

AFP is a protein that is normally produced by the developing fetus. However, it can also be produced by certain tumours. Raised levels of AFP are found in the vast majority of patients with a type of liver cancer called hepatocellular carcinoma. It is also raised in some patients with cancer of the testis.

How is the sample collected for testing?

A blood sample is taken by needle from a vein in the arm.

The Test

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 to monitor their response to 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).

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

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When is it requested?

Your physician will request an AFP blood test if:

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

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What does the test result mean?

Looking for reference ranges?

Increased AFP levels can be caused by liver cancer, germ cell tumour of the testis or less commonly other cancers (for example, stomach, bowel, lung, breast, lymphoma). Slightly increased levels of AFP are common in patients who have chronic hepatitis or cirrhosis. In these patients, an increase in AFP is more important than the actual numerical value of the test result.

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Is there anything else I should know?

In general, the higher the AFP level in patients with cancer, the bigger the tumour. 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.

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Common Questions

1.  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 too much iron), can cause cirrhosis and later hepatocellular carcinoma.

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2.  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 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 examination, a CT scan or a MRI scan. These scans can often spot liver cancers if they are present.

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3.  I have read about AFP L3 on the Internet. What is it?

Not all the AFP molecules in blood are identical, although the differences between them are small. AFP L3 is a particular type of AFP molecule that some researchers think can help doctors tell whether an increase in AFP is due to tumour or not. However, it is not yet clear that this test would provide a significant benefit in routine use and it is not available in Australia.

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.