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Liver cancer is one of the cancers that have a low survival ratio when compared to some other types of cancers; yet people can help reduce their risk of getting cancer of the liver. Although there is no way liver cancer can be prevented completely, but there are preventive measures individuals can take to help reduce their risk of having liver cancer.
Liver cancer usually occur when the liver cell in human begin to change i.e. mutations, thus causing changes to the liver. And this change could result to the cell growing abnormally and becoming a tumour.
Sometimes the cause of liver cancer is known, such as with chronic hepatitis infections. But sometimes liver cancer happens in people with no underlying diseases and it's not clear what causes it.
Primary liver cancer (hepatocellular carcinoma) tends to occur in livers damaged by birth defects, alcohol abuse, or chronic infection with diseases such as hepatitis B and C, hemochromatosis (a hereditary disease associated with too much iron in the liver), and cirrhosis.
Risk Factors
Factors that increase the risk of primary liver cancer include:
Worldwide, the most common risk factor for liver cancer is chronic infection with the hepatitis B virus. Chronic viral hepatitis infections (hepatitis B and hepatitis C) cause at least 80% of all liver cancers. In the United States, the leading cause is chronic hepatitis C virus infections because of the greater number of Americans infected with this virus. Chronic infections, however, with hepatitis B or C are responsible for making liver cancer the most common cancer in many parts of the world.
More than 50% of all liver cancers could be prevented with increased use of the hepatitis B vaccine and better treatments for chronic hepatitis B and curative treatments for hepatitis C infections.
The hepatitis B virus is classified by the International Agency for Research on Cancer as a known cancer-causing virus in humans because of the strong link between chronic hepatitis B infection and liver cancer. People chronically infected with hepatitis B are 100 times more likely to develop liver cancer than uninfected people because the virus directly and repeatedly attacks the liver. These attacks over time can lead to increasing liver damage, cirrhosis (scarring of the liver), and ultimately, liver cancer.
Among people chronically infected with hepatitis B, the risk of developing liver cancer increases as a person gets older or if they have been diagnosed with cirrhosis.
Although liver cancer most often occurs in the presence of cirrhosis, individuals with chronic hepatitis B infection can develop liver cancer without having cirrhosis.
Chronic hepatitis C infections cause cirrhosis (scarring of the liver), which can lead to liver cancer. Hepatitis C infection is more common in the United States than any other part of the world where hepatitis B infections are the most common cause of liver cancer.
People co-infected with hepatitis B, hepatitis C, or HIV have a significantly increased risk of developing liver damage, cirrhosis, and liver cancer
Hepatitis D is the most severe form of viral hepatitis and can only exist as a co-infection of hepatitis B, making all hepatitis B patients at risk. Co-infections can increase the risk of cirrhosis and liver cancer by up to three times compared to a sole hepatitis B infection and are important to identify due to the need to alter management and treatment strategies.
Globally, hepatitis D is estimated to affect 15-20 million people, or about 5-15% of all people infected with hepatitis B.
Cirrhosis occurs when damaged liver cells are replaced by scar tissue, which reduces the liver’s ability to function normally. People diagnosed with cirrhosis have an increased risk of liver cancer and require more frequent monitoring for this type of cancer.
Cirrhosis caused by chronic viral hepatitis is the most common. People living with chronic hepatitis C infections, cirrhosis is always present before liver cancer develops. Others living with chronic hepatitis B infections, however, liver cancer can develop without cirrhosis, which is why regular liver cancer screening is so important.
Smoking by itself may not cause liver cancer, but it dramatically increases the risk, especially in people who have other risk factors, such as chronic hepatitis B or C infections.
A person’s risk of developing liver cancer increases if they have a family history of liver cancer. People who had a parent, sibling, or child with liver cancer are about four times more likely to develop liver cancer than individuals without such a family history. People with hepatitis B or hepatitis C infection who also had a family history of liver cancer are also at the high risk of developing liver cancer, especially at a young age.
Aflatoxin are cancer-causing toxins (or poisons) found in molds that contaminate maize, corn, rice, soybeans, and groundnuts. These molds are more common in warmer and tropical regions, such as countries in sub-Saharan Africa and Asia where poor storage conditions may result in mold formation. The risk of liver cancer is much higher among individuals who have long-term exposure to Aflatoxin through eating roasted corn or groundnut that have been poorly stored; and also are chronically infected with hepatitis B or C.
Exposure to chemicals such as vinyl chloride and thorium dioxide can increase the risk of a type of liver cancer called angiosarcoma. Vinyl chloride is a chemical used in making certain plastics. Thorium dioxide is a chemical that was injected as part of certain x-ray tests used in the past.
Long-term exposure to drinking water that is contaminated with naturally occurring arsenic increases the risk of some types of liver cancer.
Alcohol abuse is a leading cause of cirrhosis, which in turn is linked to an increased risk of liver cancer. Excessive alcohol use may also directly cause liver cancer. Persons with chronic hepatitis B or C infections who abuse alcohol have an even higher risk of developing liver cancer.
There have been various studies which show a strong link between type II diabetes and liver cancer. Excessive fat in the liver is common among persons with type II diabetes and may increase the risk of cirrhosis and liver cancer. This risk is higher in patients who also have other risk factors, such as heavy alcohol consumption or chronic viral hepatitis infections.
Obesity, which can contribute to fatty liver disease and cirrhosis, is a major risk factor for the development of type II diabetes, which, in turn, can increase the chance of developing liver cancer.
In nonalcoholic fatty liver disease, excess fat builds up in the liver of people who drink little or no alcohol. The most severe form of nonalcoholic fatty liver disease is called nonalcoholic steatohepatitis (NASH). People with NASH have fat in their liver, along with inflammation and liver damage. They usually have no symptoms and do not know that they have a liver problem. NASH can be severe and can lead to cirrhosis.
Liver diseases that can increase the risk of liver cancer include hemochromatosis and Wilson's disease. In Wilson disease, the liver cannot filter copper at a normal rate because of a genetic alteration. The copper builds up in an affected person’s liver, resulting in liver disease and sometimes even acute liver failure.
People who have hemochromatosis absorb too much iron from their food. The excess iron can build up in the liver, causing cirrhosis that may lead to liver cancer.
In the United States, individuals of Asian and Pacific Islander descent have the highest rates of liver cancer, followed by American Indians/Alaska Natives and Hispanic/Latino populations, African Americans, and Caucasian Americans. Liver cancer is more common in men than in women no matter the race or ethnicity. Male gender increases the risk of liver cancer if the man already has liver disease. For example, men more frequently engage in behaviors such as heavy alcohol and tobacco use, which are risk factors for liver cancer. Liver cancer can strike at any age, but it mainly occurs among older adults. Young adults who are chronically infected with hepatitis B or C and have a family history of liver cancer are at increased risk. Although liver cancer is rare in children, it can occur.
Male hormones abused by athletes to increase muscle can slightly increase liver cancer risk with long-term use.
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