The invention provides methods for detecting the presence of cancer initiating cells in a tissue, methods for identifying test agent for reducing cancer, and methods for reducing cancer in a subject. The inventions methods are applicable to any cancer, and in particular to liver cancer. The invention also provides the isolation and characterization of pre-malignant hepatocellular carcinoma initiating cells (HICs). The invention further provides methods for isolating hepatocellular carcinoma initiating cells (HICs), methods for using the isolated cells for screening anti-cancer drugs, methods for using HIC markers for the early diagnosis of hepatocellular carcinoma, and methods for the prevention and/or delay of hepatocellular carcinoma by using agents that selectively deplete the number and/or malignant properties of HICs.
