Many liver cancers could be prevented by reducing exposures to known risk factors for this disease.
Avoiding and treating hepatitis infections
Worldwide, the most significant risk factor for liver cancer is chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV).
A vaccine to help prevent hepatitis B infection has been available since the early 1980s. The Centers for Disease Control and Prevention (CDC) recommends that all children, as well as adults at risk (health care workers, those whose behaviors may put them at risk, etc.) get this vaccine to reduce the risk of hepatitis and liver cancer.
There is no vaccine for hepatitis C. Preventing HCV infection, as well as HBV infection in people who have not been immunized, is based on understanding how these infections occur. These viruses can be spread through sharing contaminated needles (such as in drug use), unprotected sex, and through childbirth.
Blood transfusions were once a major source of infection as well. But because blood banks in the United States test donated blood to look for these viruses, the risk of getting a hepatitis infection from a blood transfusion is extremely low.
People at high risk for hepatitis B or C should be tested for these infections so they can be watched for liver disease and treated if needed. Several drugs can be used to treat hepatitis B and C.
Two drugs, peg-interferon and ribavirin, are often used to treat chronic hepatitis C infection. Treatment usually lasts for 6 months to a year and can eliminate the hepatitis C virus in many people. One of the problems with this treatment is that it can cause severe side effects, including flu-like symptoms, fatigue, depression, and low blood cell counts, which can make it hard to take.
A number of drugs can be used to treat chronic hepatitis B, including interferon (and peg-interferon), lamivudine (Epivir-HBV®), adefovir (Hepsera®), entecavir (Baraclude®), telbivudine (Tyzeka®), and tenofovir (Viread®). These drugs have been shown to reduce the number of viruses in the blood and lessen liver damage. Although they do not cure the disease, they lower the risk of cirrhosis and might lower the risk of liver cancer, as well.
Limiting alcohol and tobacco use
In the United States, alcohol abuse remains a major cause of the cirrhosis that can lead to liver cancer. Prevention of liver cancers linked with alcohol abuse remains a challenge. Quitting smoking may also slightly lower the risk of liver cancer, as well as lowering the risk for many other life-threatening diseases.
Limiting exposure to cancer-causing chemicals
Changing the way certain grains are stored in tropical and subtropical countries could reduce exposure to cancer-causing substances such as aflatoxins. Many developed countries already have regulations to prevent and monitor grain contamination.
Most developed countries also have regulations to protect consumers and workers from certain chemicals known to cause liver cancer. The US Environmental Protection Agency (EPA) recently lowered the allowable level of arsenic in drinking water in the United States. But this may continue to be a problem in areas of the world where naturally occurring arsenic commonly gets into drinking water.
Treating diseases that increase liver cancer risk
Certain inherited diseases can cause cirrhosis of the liver, increasing the risk for liver cancer. Finding and treating these diseases early in life could lower this risk. For example, all children in families with hemochromatosis should be screened for the disease and treated if they have it. Treatment lowers their iron intake and removes small amounts of blood to use up the body's excess stores of iron.
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