Abstract: Objective To evaluate liver cancer screening in high-incidence area, so as to analyze the distribution characteristics of positive hepatitis B surface antigen (HBsAg) among the population and screen the liver cancer patients further. Methods ELISA was used to detect the serum levels of HBsAg and alphafetoprotein( AFP). Ultrasonography was used to examine the organ of belly. Results (1) The positive rate of HBsAg was 15.7%(2889/18460). The male had higher positive rate of HBsAg than the female(P>0.01). The positive rate of HBsAg was negatively associated with age(P<0.01); (2) In first screening and follow-up, we detected 11 and 5 liver cancer patients in HBsAg positive population(high-risk population of liver cancer), respectively. The rates of early detection were 27.3%(3/11) and 40%(2/5), respectively. There were 11 liver cancer patients who missed diagnosis in the whole screening population for two years, four of them were high-risk population of liver cancer and exited the following-up, and the other seven patients were detected from HBsAg negative population. The rates of missed diagnosis were 20%(4/20) in the high-risk population and 25.9%(7/27) in the whole screening population, respectively; (3) In general population and high-risk population, the incidence of liver cancer were 49.9/105(37/74 084) and 346.1/105(20/5778) respectively (P<0.05); the rates of early detection were 8.1% (3/37) and 30.0% (6/20), respectively(P>0.05). In general population, the survival rates of 0.5-, 1- and 2-year were lower than those in high-risk population(P<0.05). Conclusion Screening liver cancer in high-incidence area, we could understand the distribution of HBsAg, screen the high-risk population and detect liver cancer patients in time, so as to increase the recent survival rate of patients. However, the rates of missed diagnosis are high in HBsAg negative population and the highrisk population with poor compliance. The early detection and survival rates should be improved in liver cancer screening.