Finding the right tests…
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Finding the right tests…
Hormonal
Alpha-fetoprotein is a protein your liver makes heavily before birth, and it normally drops to very low levels once you're grown. Your doctor doesn't usually order this test out of nowhere — it's typically requested if you already have chronic hepatitis or cirrhosis, since AFP helps track your ongoing liver cancer risk. It's also used alongside imaging for certain testicular or ovarian germ cell tumours, and to see how a diagnosed cancer is responding to treatment. A markedly elevated result in someone with cirrhosis raises real concern for liver cancer, but AFP alone never confirms anything — your doctor always pairs it with an ultrasound, CT, or MRI first.
This test measures the amount of alpha-fetoprotein circulating in your blood serum, usually reported in nanograms per millilitre, from a standard venous blood draw with no fasting required. Because AFP has a short half-life of only four to five days, your doctor can use repeat draws over a few weeks to see a treatment response emerging fairly quickly. The lab report includes a reference range for adults, since exact cutoffs vary between labs and testing methods, so ask your doctor to interpret your specific number rather than one found online.
Alpha-fetoprotein is made almost entirely by a fetus's developing liver and yolk sac, which is why it's the dominant protein in blood during the first trimester of pregnancy. After birth, your liver switches this production off, and by early childhood, AFP settles into the very low range it stays at for the rest of adult life — unless something reactivates it.
Liver cells that are dividing rapidly, whether from cancer or from ordinary regeneration after liver damage, can start making AFP again. That's why doctors watch this test closely in people with cirrhosis or chronic hepatitis, conditions that raise the long-term risk of liver cancer even though they aren't cancer themselves. Certain rare germ cell tumours of the testicle or ovary can also produce AFP, since these tumours sometimes contain yolk-sac-like tissue.
A rising AFP over repeat tests is more informative than any single number, since it shows a trend rather than a one-off reading that could reflect ordinary liver inflammation. A high AFP by itself is never a cancer diagnosis — your doctor will always follow it up with imaging before deciding what it means for you.
- Reflects liver cell activity, not cancer specifically - Most useful as a trend across repeat tests - Always interpreted alongside imaging, not alone
A high AFP can point to liver cancer or certain germ cell tumours; NCBI-reviewed literature notes that levels above 200 ng/mL in someone with cirrhosis strongly suggest liver cancer. It can also come from non-cancer causes like active hepatitis, so your doctor typically follows up with imaging before concluding anything.
No. MedlinePlus is clear that AFP results alone aren't used to screen for or diagnose cancer. It's used mainly to monitor people who already have chronic liver disease or a diagnosed cancer.
In non-pregnant adults, normal AFP is typically described as 0 to 40 ng/mL in NCBI-reviewed literature, though the exact cutoff can vary by lab and testing method. Ranges vary by lab, so always check the reference range printed on your own report.
This page is general information about the test, not medical advice. Your own report's reference ranges apply — please discuss your results with your doctor.
Not completely. Some people with liver or germ cell cancers have AFP levels that stay in the normal range, so your doctor may still order imaging even if your AFP looks fine, especially if you have other risk factors or symptoms.
There's no medical requirement described in the standard test information, but preparation can vary by centre. Ask your doctor or the centre directly when you book.
The pregnancy version screens for certain birth-related conditions in the fetus and is done at a specific week of pregnancy. This tumour marker version, used in adults, checks liver and germ cell cancer risk or treatment response instead, and the two are ordered for entirely different reasons.
That depends on why it was ordered — someone with cirrhosis being monitored long-term is tested on a different schedule than someone tracking treatment response for a diagnosed cancer. Ask your doctor what schedule applies to your situation.