Liver cancer or HCC-Hepatocellular carcinoma has the fourth highest mortality rate and represents an important public health concern, currently being the fourth cancer-related cause of death worldwide. The global age-standardized incidence rate of liver cancer is 9.5, much higher than pancreatic cancer. It is the 6 th highest in global incidence with a 5-year prevalence of about 1 million (WHO, Globocan 2020 ). The incidence is also higher in males than in females. Liver cancer has seen a steady increase in incidence in developed nations like North America. Like pancreatic cancer, liver cancer also suffers from a very high mortality rate. At 8.7 it has the 4th highest global mortality rate closely following colorectal cancer (WHO, Globocan 2020, ). Just as with pancreatic cancer, the identification of useful biomarkers for surveillance and early diagnosis of HCC, is lacking. Some risk factors for HCC are well established such as chronic hepatitis B (HBV) or C virus (HCV) infection and any chronic liver disease with severe fibrosis or cirrhosis. Clinical practice guidelines include screening techniques through imaging. However, no molecular markers have been found to be highly specific or sensitive. 174, 175 While several biomarkers have been explored, further validation is lacking for most. Table