What are the risk factors for liver cancer?

A risk factor is anything that affects a person's chance of getting a disease. Different cancers have different risk factors. Some risk factors like smoking can be controlled. Others, like a person's age or family history, can't be changed. But risk factors don't tell us everything. Having a risk factor, or even several, does not mean that a person will get cancer. And some people who get the disease have few or no known risk factors.

Risk factors for liver cancer

Gender

Men are more likely to get liver cancer than women. Much of this could be because of some of the behaviors listed below.

Race/ethnicity

In the United States, Asian Americans and Pacific Islanders have the highest rates of liver cancer, followed by American Indians/Alaska Natives and Hispanics/Latinos, African Americans, and whites.

Chronic viral hepatitis

Worldwide, the most common risk factor for liver cancer is long-term (chronic) infection with hepatitis B virus (HBV) or hepatitis C virus (HCV). These infections lead to cirrhosis and are common in many parts of the world. In the United States, hepatitis C is the more common cause of liver cancer, while in many other countries, hepatitis B is more common. These viruses can spread from person to person through sharing dirty needles (such as in drug use), unprotected sex, or childbirth. They can also be passed on through blood transfusions, but this is very rare in the United States since the start of blood product testing for these viruses. People with hepatitis A or hepatitis E infection do not have an increased risk of liver cancer.

Heavy alcohol use

Alcohol abuse is a leading cause of cirrhosis in the United States, which in turn is linked with an increased risk of liver cancer.

Cirrhosis

Cirrhosis is a disease in which liver cells are damaged and replaced with scar tissue. This can often lead to cancer. In the United States, the major causes of cirrhosis are alcohol abuse and hepatitis B and C. Non-alcoholic fatty liver is a disease in which people who don't drink alcohol develop a fatty liver. People with a type of fatty liver called non-alcoholic steatohepatitis (NASH) might go on to develop cirrhosis. There are other causes of cirrhosis as well.

Obesity

Being very overweight increases the risk of getting liver cancer. This is most likely because it can result in fatty liver disease and cirrhosis.

Type 2 diabetes

Type 2 diabetes can increase the risk of liver cancer. This is more common in people with diabetes who also have other risk factors such as obesity, heavy drinking, and/or chronic hepatitis.

Inherited metabolic diseases

Certain inherited metabolic diseases can lead to cirrhosis. People with hemochromatosis absorb too much iron from their food. The iron settles in tissues throughout the body, including the liver. If enough iron builds up in the liver, it can lead to cirrhosis and liver cancer. There are also other rare diseases that increase the risk of liver cancer.

Aflatoxins

These cancer-causing substances are made by a fungus that can get into peanuts, wheat, soybeans, ground nuts, corn, and rice. Long-term exposure to aflatoxins can increase the risk of liver cancer. In the United States and Europe, these foods are tested for aflatoxins.

Vinyl chloride and thorium dioxide (Thorotrast)

These chemicals are risk factors for some types of liver cancer. They have become much less important since Thorotrast is no longer used, and exposure to vinyl chloride is strictly controlled.

Anabolic steroids

These male hormones are used by some athletes to increase their strength. Long-term use can slightly increase the risk of liver cancer.

Arsenic

Drinking water that comes from wells in some places can have arsenic in it. This increases the risk of liver cancer and is a concern in some parts of the United States.

Tobacco use

Some studies have found a link between smoking and liver cancer, but this has been hard to study because people who smoke are also more likely to drink alcohol. The link between smoking and liver cancer seems to be strongest among people with viral hepatitis or who drink a lot of alcohol.