Risks for liver cancer

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Certain behaviours, substances or conditions can affect your risk, or chance, of developing cancer. Some things increase your risk and some things decrease it. Most cancers are the result of many risks. But sometimes cancer develops in people who don't have any risks.

lnfection with hepatitis B or C virus and cirrhosis of the liver are the main risks for liver cancer. The chance of developing liver cancer increases with age. More men than women develop liver cancer. Liver cancer is more common in countries with high rates of hepatitis B and C infection.

Some people with certain genetic conditions have a higher than average risk for liver cancer. Talk to your doctor about your risk. If you have a genetic condition that increases the risk of liver cancer, you may need to visit your doctor more often to check for liver cancer. Your doctor will recommend what tests you should have and how often you should have them.

The following can increase or decrease your risk for liver cancer. There are some things you can do to lower your risk and help protect you from developing cancer. But some of these risks cannot be changed.

Infection with hepatitis B or C virus

Cirrhosis of the liver

Alcohol

Smoking tobacco

Metabolic disorders

Non-alcoholic steatohepatitis (NASH)

Excess weight

Contact with aflatoxin

Contact with chemicals at work

Contact with thorium dioxide

Type 2 diabetes

Being physically active

Infection with hepatitis B or C virus

Hepatitis B virus (HBV) and hepatitis C virus (HCV) can cause inflammation of the liver (called hepatitis). HBV can be spread from person to person through blood or other body fluids, such as semen or vaginal fluids. HCV is spread only through contact with infected blood. Infection with either virus increases the risk for liver cancer.

Learn more about hepatitis B virus (HBV) and hepatitis C virus (HCV) and how to reduce your risk.

Cirrhosis of the liver

People who have cirrhosis of the liver have a higher risk for liver cancer. Cirrhosis is when scar tissue replaces healthy tissue in the liver. The scar tissue blocks blood flow through the liver so it can't work normally. Cirrhosis can be caused by:

  • infection with hepatitis B or C virus
  • drinking large amounts of alcohol over a long period of time
  • metabolic disorders that cause liver damage

Infection with hepatitis virus and alcohol together greatly increase your risk of cirrhosis and liver cancer.

Alcohol

Drinking alcohol increases your risk for cirrhosis, which can then increase your risk for liver cancer. The more you drink, the greater your risk.

Learn more about how to limit alcohol.

Smoking tobacco

Smoking tobacco increases your risk for liver cancer. All forms of tobacco, including cigarettes, cigars and pipes, increase your risk.

The more you smoke and the longer you smoke, the greater your risk. The risk of developing liver cancer decreases with time after you quit smoking.

Learn more about how to live smoke-free.

Metabolic disorders

People who have certain genetic conditions that interfere with metabolism have a higher risk of developing liver cancer. These conditions may lead to liver failure or cirrhosis of the liver.

Hemochromatosis (also called iron overload) is a disorder that causes the body to store higher than normal amounts of iron. The extra iron builds up in different tissues, especially the liver. When the liver stores too much iron, and the condition is not treated, the liver may be damaged. People with untreated hemochromatosis have a higher risk of developing liver cancer.

Other metabolic disorders that may increase the risk of liver cancer include:

  • alpha-1 antitrypsin deficiency
  • porphyria cutanea tarda and acute intermittent porphyria
  • hereditary tyrosinemia
  • type I and III glycogen storage disease

Non-alcoholic steatohepatitis (NASH)

Non-alcoholic steatohepatitis (NASH) is a more advanced form of non-alcoholic fatty liver disease (NAFLD). In NAFLD, fat cells collect in the liver of people who do not drink large amounts of alcohol. The main risk factor for developing NAFLD is having obesity.

In NASH, the fatty tissue in the liver becomes inflamed and causes scar tissue to form (cirrhosis).

By itself, NAFLD does not cause any significant liver damage or increase the risk of liver cancer. But NASH may progress to liver damage and cirrhosis, which increases the risk of developing liver cancer.

Excess weight

Overweight and obesity can increase the risk for liver cancer. This may be because excess weight can increase the risk of NASH and cirrhosis.

Learn more about how to have a healthy body weight.

Contact with aflatoxin

Aflatoxin is a type of toxin made by moulds and fungi (called a mycotoxin). It can contaminate many different foods, including corn, rice, wheat, peanuts, soybeans and sunflower seeds. It can also be found on spices, such as ginger or chilli peppers, and on nuts, including almonds, walnuts and pistachios.

Aflatoxin can be a problem in countries with hot, damp climates and poor storage facilities. People are most likely to come into contact with aflatoxin in Africa and Asia because there are high levels of contamination in food, stored grains, soil and water.

Aflatoxin is not a concern in Canada. The Canadian Food Inspection Agency monitors and tests nuts and nut products, as well as some dairy products, for aflatoxin contamination.

Contact with chemicals at work

Coming into contact with the following chemicals at work increases the risk for liver cancer.

Vinyl chloride is used in the plastics industry to make polyvinyl chloride (PVC), which is used in many products. Coming into contact with vinyl chloride increases the risk of developing both angiosarcoma (a rare type of liver cancer) and hepatocellular carcinoma.

Plutonium is a radioactive substance. Workers who accidentally breathe in plutonium have a higher risk of developing angiosarcoma.

Learn more about what you can do to be safe at work.

Contact with thorium dioxide

Thorium dioxide (Thorotrast) is a radioactive solution. It was used as a contrast medium in the 1950s to improve x-rays of the blood system, nasal passages and sinus cavities. After it is injected, thorium dioxide collects in the liver, spleen and bone marrow.

People who came in to contact with thorium dioxide have a greater risk of developing angiosarcoma. The higher the dose given, the greater the risk. Cancer may develop as many as 45 years after you come into contact with it.

Type 2 diabetes

People with type 2 diabetes may have a higher risk of developing liver cancer. Studies show that people with type 2 diabetes who develop liver cancer sometimes have other risk factors, such as heavy alcohol use, hepatitis infection or both. Also, many people with type 2 diabetes tend have excess weight, which may also increase their risk for liver cancer.

Being physically active

Being physically active reduces your risk for liver cancer.

Learn more about how to move more, sit less.

Possible risks

The following have been linked with liver cancer, but there is not enough evidence to know for sure that they are risks. More research is needed.

  • birth control pills
  • infection with a liver fluke (a parasite that infects the liver)
  • contact with arsenic, trichloroethylene, polychlorinated biphenyls (PCBs) or dichlorodiphenyltrichloroethane (DDT)
  • chewing betel quid
  • eating fish

Understanding your cancer risk

To make the decisions that are right for you, ask your doctor questions about risks. Learn how cancer can be prevented and what you can do to reduce your risk.

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