Can liver cancer be prevented?

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). These viruses can spread from person to person through sharing contaminated needles (such as in drug use) and through unprotected sex, so some of these cancers may be prevented by not sharing needles and by using safer sex practices (such as consistent use of condoms).

A vaccine to help prevent hepatitis B infection has been available since the early 1980s. The US 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.

Treatment of chronic hepatitis C infection with 2 drugs (peg-interferon and ribavirin) for about 6 months to a year can eliminate HCV 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. 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 is a major cause of cirrhosis, which can lead to liver cancer. Preventing liver cancers linked with alcohol abuse remains a challenge.

Quitting smoking might also slightly lower the risk of liver cancer, as well as many other life-threatening diseases.

Getting to and staying at a healthy weight

Avoiding obesity might be another way to help protect against liver cancer. People who are obese are more likely to have fatty liver disease and diabetes, both of which have been linked to liver cancer.

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. For example, the US Environmental Protection Agency (EPA) limits 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 regularly removes small amounts of blood to lower the amount of excess iron in the body.