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Liver cancer: Risks and prevention

An older man talks to his doctor

Hepatitis and cirrhosis are common risk factors for liver cancer.

There are no broadly recommended screening tests for liver cancer, but some risk factors have been identified, and you can reduce your risk.

According to the American Cancer Society (ACS), risk factors for liver cancer include:

Being a man. Liver cancer is nearly three times more common in men than in women.

Viral hepatitis. Chronic infection with the hepatitis B virus (HBV) or the hepatitis C virus (HCV) raises the risk of liver cancer.

Cirrhosis. Most cases of cirrhosis develop over years of heavy drinking, as scar tissue builds up and causes increasing liver damage. Cirrhosis can also be caused by HBV, HCV or a disease called hemochromatosis, which causes iron to build up in the liver.

Tobacco. Smoking increases the risk of liver cancer, even in former smokers. However, the risk is lower for those who have quit than for current smokers.

Diabetes. Liver cancer is more common in people who have type 2 diabetes, especially if they also drink heavily or have hepatitis.

Obesity. Obesity can increase the risk for liver cancer by causing fatty liver disease and cirrhosis.

Steroids. Long-term use of muscle-building anabolic steroids can slightly increase the risk of liver cancer.

Race/ethnicity. Asian Americans and Pacific Islanders have the highest rates of liver cancer in the U.S., followed by American Indians/Alaska Natives, Hispanics/Latinos, Blacks and whites.

Toxins. Exposure to some substances and chemicals can increase liver cancer risk. These include arsenic in drinking water, vinyl chloride in the workplace and aflatoxin, which can form on stored nuts and grains. Exposure to these toxins is unlikely in the U.S. due to federal standards for food, water and workplace safety, but they remain a problem in many other countries.

Metabolic disorders. Some rare inherited diseases, such as tyrosinemia, alpha1-antitrypsin deficiency, porphyria cutanea tarda and Wilson disease, can increase the risk of liver cancer.

The ACS offers these suggestions to help reduce your risk for liver cancer:

  • Get the HBV vaccine. All children, and all adults at high risk for HBV, should get vaccinated. Risk factors for HBV include working in a healthcare setting, having sex with someone who has HBV, having multiple sex partners, injecting drugs, living with someone who has HBV, traveling to countries where HBV is common, receiving hemodialysis treatment and being a man who has sex with other men.
  • Avoid HCV. This virus is most often spread through contaminated needles when people inject drugs or are accidentally stuck by contaminated needles in a work setting. Less often, it spreads through blood products made before 1987, hemodialysis treatments or sexual intercourse with an infected person.
  • Get tested for hepatitis. If you're at risk for HBV or HCV because of your work, living situation, past medical treatments or lifestyle, ask your doctor about getting tested. The Centers for Disease Control and Prevention also recommends getting tested for HCV if you were born from 1945 through 1965.
  • Know the risks of alcohol. Cirrhosis, which can lead to liver cancer, is usually the result of long-term heavy drinking.
  • If you smoke, quit. Quitting may lower your risk for liver cancer, and it will lower your risk for other deadly diseases.
  • Take care of other diseases. If you have any disease (such as diabetes) that could increase your risk for liver damage, get medical treatment.

    Reviewed 7/10/2023

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