Provided are methods, assays, and kits for detecting hepatocellular carcinoma, as well as methods for stratifying subjects among higher and lower risk categories for having hepatocellular carcinoma, and methods of treating and managing treatment of subjects that are suspected or at risk of having hepatocellular carcinoma. Although previous work has attempted to address the need for a highly sensitive, early predictor of hepatocellular carcinoma by assessment of one or more biological factors, none have approached the degree of sensitivity that is required for clinically relevant determination of whether a subject, especially a non-symptomatic subject, has that condition. The present inventors have discovered that certain combinations of factors fulfill this need by conferring a high level of accuracy that was not previously attainable.