A risk factor is any factor that is associated with increasing someone’s chances of developing a certain condition, such as cancer. Some risk factors are modifiable, such as lifestyle or environmental risk factors. Others cannot be modified, such as inherited factors or whether someone in the family has had cancer.

Having one or more risk factors does not mean that you will develop cancer. Many people have at least one risk factor but will never develop cancer, while others with cancer may have had no known risk factors. Even if a person with cancer has a risk factor, it is usually hard to know how much that risk factor contributed to the development of their disease.

Although the causes of liver cancer are not fully understood, there are a number of factors associated with the risk of developing the disease.^[1]

Liver cancer and cirrhosis

Increasing age is an important risk factor for liver cancer. 

In Australia, men are 3 times more likely to be diagnosed with liver cancer than women. 

Other risk factors for liver (hepatocellular) cancer include the following: 

• Cirrhosis: People with liver cancer often have underlying liver disease, called cirrhosis of the liver. This is where healthy liver cells are replaced by scar tissue.
• long-term (chronic) infection with hepatitis B or C
• drinking too much alcohol
• metabolic dysfunction-associated steatotic liver disease (MASLD) (also called non-alcoholic fatty liver disease 
• having too much iron in the body (haemochromatosis).
• certain autoimmune conditions, e.g. primary biliary cirrhosis
• a family history of liver cancer
• being overweight or obese
• type 2 diabetes
• smoking

If you are concerned about your risk for liver cancer, please see your doctor.

Hepatitis and liver cancer^[3]

Hepatitis B and C are viruses that spread through contact with blood and body fluids.

The most common time people get hepatitis B is early in life. Babies can get hepatitis B from their mother. This can happen before or during birth. 

• Some other ways you can get hepatitis B are: 
• having vaginal, anal or oral sex without a condom 
• tattooing or body piercing with unsterile equipment 
• medical procedures with unsterile equipment 
• sharing needles, syringes or other injecting equipment, including spoons. 

When viral hepatitis infects the liver , the immune system attacks the virus and causes the liver to become swollen (inflamed). This infection is usually cleared by the immune system. If infection lasts more than 6 months, the liver inflammation may lead to cirrhosis. Cirrhosis increases the risk of developing primary liver cancer.

If you have hepatitis B, you may have regular tests to make sure you don’t develop liver problems. If you do have any liver damage, you may be given medicines that help manage the infection and prevent further damage.

If you have hepatitis C, you may be given a medicine that can cure the infection in most people.

Even after successful hepatitis treatment, people with cirrhosis need to have regular check-ups with their doctor. People at high risk, including people with chronic hepatitis B, cirrhosis or family history of liver cancer can have regular check-ups with their doctors to find cancer at an early stage.

Prevention of liver cancer

The hepatitis B vaccine offers effective protection against infection with Hepatitis B.

Hepatitis B vaccination is recommended as part of routine childhood immunisation. For adults, the vaccine is free on the National Immunisation Program Schedule, although a consultation fee may apply. To receive hepatitis B immunisation, visit your local doctor or immunisation provider.

Treatments for hepatitis B and hepatitis C can reduce the risk of liver cancer. Talk to your GP or your local health service to find out more.