Liver (Hepatocellular) Cancer Prevention (PDQ®): Prevention - Patient Information [NCI]
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.
What is Prevention?
Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.
To prevent new cancers from starting, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.
Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk, but it does not mean that you will not get cancer.
Different ways to prevent cancer are being studied, including:
- Changing lifestyle or eating habits.
- Avoiding things known to cause cancer.
- Taking medicines to treat a precancerous condition or to keep cancer from starting.
General Information About Liver (Hepatocellular) Cancer
Liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver.
The liver is one of the largest organs in the body. It has two lobes and fills the upper right side of the abdomen inside the rib cage. Three of the many important functions of the liver are:
- To filter harmful substances from the blood so they can be passed from the body in stools and urine.
- To make bile to help digest fats from food.
- To store glycogen (sugar), which the body uses for energy.
Anatomy of the liver. The liver is in the upper abdomen near the stomach, intestines, gallbladder, and pancreas. The liver has a right lobe and a left lobe. Each lobe is divided into two sections (not shown).
See the following PDQ summaries for more information about liver (hepatocellular) cancer:
- Liver (Hepatocellular) Cancer Screening
- Adult Primary Liver Cancer Treatment
- Childhood Liver Cancer Treatment
Liver cancer is not common in the United States, but it is common in other parts of the world.
Liver cancer is the fifth most common cancer in men, the ninth most common cancer in women, and the second leading cause of cancer death in the world. It is most common in sub-Saharan Africa and parts of eastern Asia, including China, Hong Kong, and Taiwan. In the United States, rates of liver cancer are lowest in whites and highest in Hispanic men and American Indian/Alaska Native women. The number of new cases of liver cancer continues to increase, making it the fourth leading cause of cancer deaths in the United States.
Finding and treating liver cancer early may prevent death from liver cancer.
Being infected with certain types of the hepatitis virus can cause hepatitis and may lead to liver cancer.
Hepatitis is most commonly caused by the hepatitis virus. Hepatitis is a disease that causes inflammation (swelling) of the liver. Damage to the liver from hepatitis that lasts a long time can increase the risk of liver cancer.
Hepatitis B (HBV) and hepatitis C (HCV) are two types of the hepatitis virus. Chronic infection with HBV or HCV can increase the risk of liver cancer.
HBV is caused by contact with the blood, semen, or other body fluid of a person infected with HBV virus. The infection can be passed from mother to child during childbirth, through sexual contact, or by sharing needles that are used to inject drugs. It can cause scarring of the liver (cirrhosis) that may lead to liver cancer.
HCV is caused by contact with the blood of a person infected with HCV virus. The infection can be spread by sharing needles that are used to inject drugs or, less often, through sexual contact. In the past, it was also spread during blood transfusions or organ transplants. Today, blood banks test all donated blood for HCV, which greatly lowers the risk of getting the virus from blood transfusions. It can cause scarring of the liver (cirrhosis) that may lead to liver cancer.
Liver (Hepatocellular) Cancer Prevention
Avoiding risk factors and increasing protective factors may help prevent cancer.
Avoiding cancer risk factors may help prevent certain cancers. Risk factors include smoking, being overweight, and not getting enough exercise. Increasing protective factors such as quitting smoking and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.
Chronic Hepatitis B and C infections are risk factors that may lead to liver cancer.
Having chronic hepatitis B (HBV) or chronic hepatitis C (HCV) increases the risk of developing liver cancer. The risk is even higher for people with both HBV and HCV, and for people who have other risk factors in addition to the hepatitis virus. Men with chronic HBV or HCV infection are more likely to develop liver cancer than are women with the same chronic infection.
Chronic HBV infection is the leading cause of liver cancer in Asia and Africa. Chronic HCV infection is the leading cause of liver cancer in North America, Europe, and Japan.
The following are other risk factors that may increase the risk of liver cancer:
The risk of developing liver cancer is increased for people who have cirrhosis, a disease in which healthy liver tissue is replaced by scar tissue. The scar tissue blocks the flow of blood through the liver and keeps it from working as it should. Chronic alcoholism and chronic hepatitis infections are common causes of cirrhosis. People with HCV-related cirrhosis have a higher risk of developing liver cancer than people with cirrhosis related to HBV or alcohol use.
Heavy alcohol use
Heavy alcohol use can cause cirrhosis, which is a risk factor for liver cancer. Liver cancer can also occur in heavy alcohol users who do not have cirrhosis. Heavy alcohol users who have cirrhosis are ten times more likely to develop liver cancer, compared with heavy alcohol users who do not have cirrhosis.
Studies have shown there is also an increased risk of liver cancer in people with HBV or HCV infection who use alcohol heavily.
The risk of developing liver cancer may be increased by eating foods that contain aflatoxin B1 (poison from a fungus that can grow on foods, such as corn and nuts, that have been stored in hot, humid places). It is most common in sub-Saharan Africa, Southeast Asia, and China.
Nonalcoholic steatohepatitis (NASH)
Nonalcoholic steatohepatitis (NASH) is a condition that can cause scarring of the liver (cirrhosis) that may lead to liver cancer. It is the most severe form of nonalcoholic fatty liver disease (NAFLD), where there is an abnormal amount of fat in the liver. In some people, this can cause inflammation (swelling) and injury to the cells of the liver.
Having NASH-related cirrhosis increases the risk of developing liver cancer. Liver cancer has also been found in people with NASH who do not have cirrhosis.
Cigarette smoking has been linked to a higher risk of liver cancer. The risk increases with the number of cigarettes smoked per day and the number of years the person has smoked.
Certain rare medical and genetic conditions may increase the risk of liver cancer. These conditions include the following:
- Untreated hereditary hemochromatosis (HH).
- Alpha-1 antitrypsin (AAT) deficiency.
- Glycogen storage disease.
- Porphyria cutanea tarda (PCT).
- Wilson disease.
The following protective factors may decrease the risk of liver cancer:
Hepatitis B vaccine
Preventing HBV infection (by being vaccinated for HBV as a newborn) has been shown to lower the risk of liver cancer in children. It is not yet known if being vaccinated lowers the risk of liver cancer in adults.
Treatment for chronic hepatitis B infection
Treatment options for people with chronic HBV infection include interferon and nucleos(t)ide analog (NA) therapy. These treatments may reduce the risk of developing liver cancer.
Reduced exposure to aflatoxin B1
Replacing foods that contain high amounts of aflatoxin B1 with foods that contain a much lower level of the poison can reduce the risk of liver cancer.
Cancer prevention clinical trials are used to study ways to prevent cancer.
Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.
The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.
New ways to prevent liver cancer are being studied in clinical trials.
Information about clinical trials supported by NCI can be found on NCI's clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
About This PDQ Summary
Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.
PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.
Purpose of This Summary
This PDQ cancer information summary has current information about liver (hepatocellular) cancer prevention. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.
Reviewers and Updates
Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.
Clinical Trial Information
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
Permission to Use This Summary
PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as "NCI's PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary]."
The best way to cite this PDQ summary is:
PDQ® Screening and Prevention Editorial Board. PDQ Liver (Hepatocellular) Cancer Prevention. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/liver/patient/liver-prevention-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389299]
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Last Revised: 2020-04-21
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