Risk Factors

Gender. Hepatocellular carcinoma is more common in males than in females.

Chronic viral hepatitis infection. Chronic (long-term) infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) is a very important liver cancer risk factor. These infections are responsible for making liver cancer the most common cancer in many parts of the world.

Cirrhosis of the liver. Cirrhosis is the result of scar tissue formation in the liver. Most people who have cirrhosis of the liver in the United States have a history of alcohol abuse. Cirrhosis can also be caused by hepatitis B and C or by your body absorbing too much iron from food, causing an excess of iron in the liver (hemochromatosis).

Tobacco use. Several studies have found a link between smoking and liver cancer, although the extent of this link is not known.

Inherited metabolic diseases. Rare diseases that increase the risk of liver cancer include tyrosinemia, alpha1-antitrypsin deficiency, porphyria cutanea tarda and Wilson's disease.

Aflatoxins. These carcinogenic (cancer-causing) substances are produced in tropical and subtropical regions by a fungus that contaminates peanuts, wheat, soybeans, ground nuts, corn and rice. Long-term exposure to these substances increases the risk of hepatocellular carcinoma.

Vinyl chloride and thorium dioxide (Thorotrast). These chemicals are risk factors for angiosarcoma and hemangiosarcomas. They have become much less important because Thorotrast is no longer used and exposure of workers to vinyl chloride is strictly regulated.

Anabolic steroids. Anabolic steroids are male hormones that are used by some athletes to increase their strength. Long-term anabolic steroid use can slightly increase the risk of hepatocellular cancer. Cortisone-like steroids, such as hydrocortisone and dexamethasone, do not carry this same risk.

Arsenic. Chronic exposure to drinking water contaminated with naturally occurring arsenic, such as that obtained from some wells, increases the risk of hepatocellular cancer. This is more common in parts of East Asia, but may be a concern in areas of the United States also.

Diabetes. Some studies suggest that people with diabetes have a higher chance of getting liver cancer than people without diabetes.

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