Preview Although hepatocellular carcinoma is rare in the United States, it is a serious disease that will likely increase in incidence with the changing patterns of immigration. The vast majority of patients with hepatocellular carcinoma have been exposed to hepatitis B or hepatitis C, and all three diseases have the same geographic distribution. Thus, a link between the diseases seems indisputable. The authors define the populations at risk for hepatocellular carcinoma and describe the availability and use of screening methods.