Routine surveillance for hepatocellular carcinoma (HCC) among people with chronic hepatitis B infection with abdominal ultrasound and alphafetoprotein testing every six months is recommended if there is no family history of HCC or evidence of cirrhosis, people older than 40 years (a lower age may apply depending on the regional incidence of HCC) and with HBV DNA level >20,000 IU/mL (if HBV DNA testing is available).