Primary liver cancer (PLC) is one of the common malignant tumors and the main causes of tumor death in China. Although the diagnosis and treatment technology of PLC in China has made great progress in recent years, its morbidity and mortality have been decreasing year by year, but the low early diagnosis rate and 5-year survival rate of PLC are major public health problems that need to be solved urgently in the field of chronic disease prevention and control. Effective implementation of early screening, detection, diagnosis and treatment of PLC is an important measure to improve the rates of radical treatment and survival. The combination of serum alpha-fetoprotein (AFP) and liver ultrasound is a routine method for screening hepatocellular carcinoma (HCC) in patients with chronic liver disease; the combination of AFP and AFP-L3 and/or abnormal prothrombin can improve the early diagnosis rate of early-stage HCC; the early diagnosis rate of small hepatocellular carcinoma can be improved by Gd-EOB-DTPA-enhanced magnetic resonance imaging or its combination with computerized tomography. With the continuous promotion of hierarchical medical system and improvement of primary medical resources allocation and health service capacity in China, primary care institutions have become an important force for early screening of many cancers. Based on this context, this paper mainly discusses the development opportunities, risk challenges and future thinking of surveillance for liver cancer in primary care institutions in China, in order to provide new ideas and direction guidance for it in the future.

原发性肝癌（以下简称肝癌）是我国常见恶性肿瘤，严重威胁了我国人民的生命和健康。尽管近年来我国的肝癌诊疗技术取得较大进步，其发病率和死亡率有逐年下降趋势，但早期诊断率低，5年生存率低，是慢性病防控领域亟待解决的重大公共卫生问题。切实有效实施肝癌早筛计划、早发现、早诊断、早治疗是提高根治性治疗率和生存率的重要措施。血清甲胎蛋白（AFP）联合肝脏超声是慢性肝病患者筛查肝细胞癌（HCC）的常规手段，AFP联合AFP-L3和/或异常凝血酶原可提高早期HCC的早期诊断率；钆塞酸二钠增强核磁共振或联合电子计算机断层扫描可提高小肝癌的早期诊断率。随着我国分级诊疗制度的不断推进，基层医疗资源配置和卫生服务能力的持续提升，基层医疗卫生机构已成为许多癌症早期筛查的重要力量。基于此背景，本文主要论述了中国肝癌基层筛查的发展机遇、风险挑战及对未来的思考，旨在为未来的肝癌基层筛查工作提供新的思路与方向指导。