Hepatocellular Carcinoma (HCC) is the third most common cause of cancer death worldwide. Unlike most other cancers, mortality from HCC is on the rise. The majority of HCC develops on the background of chronic liver disease providing a well-defined population to screen. The current standard of care for screening is hindered by complex logistics of bi-annual hospital visits for ultrasound scanning of the liver and blood testing for the protein biomarker Alpha Fetoprotein. Both of which provide a detection sensitivity of about 60% for HCC within a curable stage. Next Generation Sequencing (NGS) studies have demonstrated that copy number alterations (CNAs) are frequent and early features in hepatocarcinogenesis. NGS is relatively costly and not available in every diagnostic lab therefore its potential translation as a population screening tool in the current NHS economic context is challenging. In this talk, we will describe the potential to screen for CNAs using a PCR-based technique called the Paralogue Ratio Test.