The short answer
Hepatitis C can lead to liver cancer through long-term inflammation. Modern antivirals cure over 95 percent of infections. Cure removes the virus, but scarring that is already there can still carry risk.
CDC recommends that all adults aged 18 and older be tested for hepatitis C at least once, and during each pregnancy — most people with the infection have no symptoms.
CDC estimates 2.4 to 4 million people in the United States were living with hepatitis C in 2017 to 2020, and more than half of people exposed develop chronic infection.
Direct-acting antiviral treatment cures more than 95 percent of infections, usually in 8 to 12 weeks.
CDC says people with hepatitis C and cirrhosis face a 1 to 4 percent chance of liver cancer each year.
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Watch: Hepatitis C: the test everyone should get once
1 min · Captioned · Hepatitis C is silent, common, and over 95% curable — CDC says test once.
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The whole article, with every detail and caution.
This page is for anyone who has hepatitis C, has been cured of it, or is not sure whether they have been tested. It explains how the virus leads to liver cancer, how testing works, and why some people still need checks after a cure.
A slow, silent process
Hepatitis C is a virus spread through blood that infects liver cells. CDC says more than half of people exposed to it develop chronic infection, which can last a lifetime if untreated. Many people have no symptoms.
What it does cause is steady, mild inflammation (swelling and irritation). Over time, that inflammation can lead to fibrosis, which means scarring. CDC says about 5 to 25 percent of people with untreated chronic hepatitis C develop cirrhosis, a heavy and lasting form of scarring, over 10 to 20 years. Cirrhosis raises the risk of hepatocellular carcinoma, cancer that starts in liver cells. NCI says chronic hepatitis C infection can lead to liver cancer.
An estimated 2.4 to 4 million people in the United States were living with hepatitis C between 2017 and 2020.
Testing is the only way to find it
CDC recommends that all adults aged 18 and older be tested at least once. That holds whether or not they have any risk factor. Pregnant people should be tested during each pregnancy.
Repeat testing is recommended for people with ongoing exposure. That includes:
- People who inject drugs and share equipment
- People on long-term kidney dialysis (hemodialysis)
One-time testing is also advised for:
- People with HIV
- People with abnormal liver tests
- People who received blood transfusions before July 1992
- Anyone after a needlestick injury at work
Being asked about it is not an accusation.
Diagnosis takes two steps. An antibody test shows whether you have ever been exposed. If it is positive, an HCV RNA test shows whether the virus is still present. Antibodies stay in the blood after the body clears the virus on its own. They also stay after a cure. So the RNA result is the one that answers the question. If your record holds a positive antibody test and no RNA result, that gap is worth closing.
What treatment changes
Direct-acting antiviral medicines cure more than 95 percent of hepatitis C infections. Treatment is usually 8 to 12 weeks of tablets. Most people have few side effects. Doctors call a cure a sustained virologic response. It means no virus can be found twelve weeks after treatment ends.
Curing the infection removes the virus from the body. Ask your care team how a cure affects your own liver cancer risk.
Even so, only about one in three people diagnosed in the United States has been cured. That figure comes from CDC's national hepatitis C clearance cascade analysis. Cost, insurance requirements, and access are real barriers. A case manager or patient navigator can sometimes help with them. Whether treatment is right for you, and which medicines, is a choice to make with your care team.
Why surveillance continues after cure
This is the part most often misunderstood. Cure removes the virus. It does not remove the scarring the virus already caused.
In people with hepatitis C and cirrhosis who are not treated, the yearly risk of liver cancer is roughly 1 to 4 percent. Cure removes the virus, but it does not remove scarring that is already there.
For this reason, AASLD-IDSA guidance recommends liver cancer surveillance for people with cirrhosis. That means an ultrasound, with or without an AFP blood test, every 6 months. Ask your care team how long you should continue.
The guidance we checked sets out surveillance for people with cirrhosis. So bring a clear question to your care team: do I have cirrhosis, how was that determined, and does that put me in the surveillance group?
What else you can do
Other things may add to liver cancer risk. Alcohol can further harm the liver. Your care team may also advise on hepatitis A and B vaccines and on how to avoid getting hepatitis C again.
Sources
Common questions
I feel completely well. Why would I be tested?
Because many people with hepatitis C have no symptoms. CDC says testing is the only way to find out. CDC recommends one-time testing for every adult 18 and older.
My antibody test was positive. Does that mean I have hepatitis C now?
Not necessarily. A positive antibody test means you were exposed at some point. Some people clear the virus on their own, and antibodies remain afterwards. A follow-up HCV RNA test determines whether the virus is still present. Both results together give the answer, so it is worth confirming that the second test was done.
If treatment cures the infection, why would I still need scans?
Because cure addresses the virus, not the scarring it left behind. Cirrhosis itself carries ongoing liver cancer risk. The AASLD-IDSA guidance recommends surveillance for people with cirrhosis, using ultrasound with or without an AFP blood test every 6 months.
I do not have cirrhosis. Do I need surveillance after cure?
The guidance we checked sets out surveillance for people with cirrhosis. Whether it applies to you depends on your liver scarring (fibrosis) stage, so ask your care team.
What else raises my liver cancer risk on top of hepatitis C?
Your care team can tell you what else may add to your own liver cancer risk. Alcohol can further harm the liver, so ask about it.
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Written by: Cancer ExplainedSources last checked: 2026-10-16 what this meansLast updated: 2026-10-16Next planned review: 2027-07-30
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes, and this is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and then compared with the sources listed on it, looking for statements those sources do not back up. That check is not a sentence-by-sentence record and can miss errors. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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