Risk Factors for Liver Cancer

This is the third article in the Understanding Liver Cancer Guide. This guide was developed by the HealthTree Education Team and was last updated and reviewed on June 20, 2026. 

Anything that increases your chance of developing cancer is called a risk factor. Having one or more risk factors does not guarantee you will develop liver cancer. It is also possible to develop liver cancer without any known risk factors. Researchers continue to learn about the factors that make liver cancer more or less likely to develop.

Most risk factors for hepatocellular carcinoma, the most common type of liver cancer, cause damage to the liver over many years. This damage leads to cirrhosis, which is the most important risk factor for liver cancer in the United States and worldwide.

What raises your risk for developing liver cancer?

• Cirrhosis. Cirrhosis is the most important risk factor for hepatocellular carcinoma. It results from long-term liver damage and involves widespread scarring that replaces healthy liver tissue. Almost any cause of chronic liver disease can lead to cirrhosis, and cirrhosis from any cause raises the risk of liver cancer significantly.
• Chronic hepatitis B infection. Hepatitis B is caused by the hepatitis B virus, which is spread through blood, sexual contact, and from mother to child during birth. Long-term hepatitis B infection can cause liver cancer even in people who have not developed cirrhosis. It is the leading cause of liver cancer worldwide, especially in Asia and sub-Saharan Africa.
• Chronic hepatitis C infection. Hepatitis C is caused by the hepatitis C virus, which is spread mainly through blood. It is a leading cause of liver cancer in the United States and Europe. Unlike hepatitis B, hepatitis C almost always causes liver cancer through the development of cirrhosis first. Effective antiviral treatments can now cure most cases of hepatitis C, which significantly reduces the risk of liver cancer.
• Heavy alcohol use. Drinking large amounts of alcohol over many years damages liver cells and can lead to cirrhosis, which in turn raises the risk of liver cancer. Heavy alcohol use combined with hepatitis B or C infection greatly increases the risk.
• Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. A buildup of fat in the liver not caused by alcohol is called nonalcoholic fatty liver disease. When fat buildup leads to inflammation and scarring, it is called nonalcoholic steatohepatitis. These conditions are the fastest-growing causes of liver cancer in the United States.
• Obesity and type 2 diabetes. Obesity and type 2 diabetes are closely linked to nonalcoholic fatty liver disease and independently raise the risk of liver cancer. They are increasingly important risk factors as their rates continue to rise.
• Aflatoxin exposure. Aflatoxins are poisons made by molds that grow on food crops such as peanuts, corn, and grains, especially in warm, humid climates. Eating food contaminated with aflatoxins over time increases the risk of liver cancer. Aflatoxin exposure is particularly important in parts of sub-Saharan Africa and Asia.
• Hereditary hemochromatosis. An inherited condition in which the body absorbs too much iron, leading to iron buildup in the liver and other organs. If untreated, it can lead to cirrhosis and liver cancer.
• Wilson disease. A rare inherited condition that causes copper to accumulate in the liver and other organs, leading to liver damage and, in some cases, cirrhosis.
• Primary biliary cholangitis and other chronic liver diseases. Conditions that cause long-term inflammation and damage to the bile ducts or liver tissue can increase the risk of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma.
• Anabolic steroids. Long-term use of anabolic steroids, synthetic hormones sometimes misused to build muscle, has been associated with an increased risk of liver cancer.
• Vinyl chloride and thorotrast exposure. These chemicals, which have been used in certain industrial processes, are associated with angiosarcoma of the liver, a rare type of liver cancer.
• Gender and age. Liver cancer is about two to three times more common in men than in women. It is most often diagnosed in people over the age of 55 in the United States.

Factors that may lower your risk

• Getting vaccinated against hepatitis B. The hepatitis B vaccine is highly effective at preventing hepatitis B infection and the liver damage and liver cancer that can result from it. It is recommended for all infants and for adults who are at risk.
• Getting treated for hepatitis C. Effective antiviral medicines can now cure most cases of hepatitis C. Curing hepatitis C significantly reduces the risk of cirrhosis and liver cancer. If you have hepatitis C, talk to your doctor about treatment options.
• Limiting alcohol. Not drinking alcohol, or drinking only in moderation, reduces the risk of liver damage, cirrhosis, and liver cancer.
• Maintaining a healthy weight. Obesity is linked to nonalcoholic fatty liver disease and type 2 diabetes, both of which raise the risk of liver cancer. Regular physical activity and a healthy diet can reduce this risk.
• Managing diabetes. Keeping blood sugar well controlled if you have type 2 diabetes may help lower the risk of liver cancer.
• Getting screened regularly if you are at high risk. People with cirrhosis or chronic hepatitis B should have regular liver ultrasound tests and blood tests to look for early signs of liver cancer. Finding liver cancer early, when it is small, gives the best chance of curative treatment.