Hepatoeellular carcinoma (HCC) is a devastating disease whcre worldwide incidence and mortality are broadly similar, emphasizing its lethality.Most HCCs occur in cirrhosis, principally from infection by the hepatitis B and C viruses (HBV and HCV).The key to improved survival is early diagnosis when tumour numbers and size are low.Alphafetoprotein and ultrasound lack sensitivity and are expensive, limiting their availability to most patients.Improved methods of detecting turnours early in at risk populations are urgently needed.