Liver cancer risk

Preventable cases

Liver cancer cases are preventable, UK, 2015

Caused by obesity

Liver cancer cases caused by overweight and obesity, UK, 2015

 

Caused by smoking

Liver cancer cases caused by smoking, UK, 2015

 

Caused by infections

Liver cancer cases caused by infections, UK, 2015

 

The estimated lifetime risk of being diagnosed with liver cancer is 1 in 130 (1%) for females, and nearly 1 in 76 (1%) for males born in 1961 in the UK. [1]

These figures have been calculated on the assumption that the possibility of having more than one diagnosis of liver cancer over the course of a lifetime is very low ('Current Probability' method).[2]

See also

Lifetime risk for all cancers combined and cancers compared

Liver cancer incidence statistics

How risk is calculated

Want to generate bespoke preventable cancers stats statements? Download our interactive statement generator.

References

  1. Lifetime risk estimates calculated by the Cancer Intelligence Team at Cancer Research UK 2023.
  2. Estève J, Benhamou E, Raymond L. Statistical methods in cancer research. Volume IV. Descriptive epidemiology. IARC Sci Publ. 1994;(128):1-302.

About this data

Data is for UK, past and projected cancer incidence and mortality and all-cause mortality rates for those born in 1961, ICD-10 C15.

Calculated by the Cancer Intelligence Team at Cancer Research UK, 2023 (as yet unpublished). Lifetime risk of being diagnosed with cancer for people in the UK born in 1961. Based on method from Esteve et al. 1994 [2], using projected cancer incidence (using data up to 2018) calculated by the Cancer Intelligence Team at Cancer Research UK and projected all-cause mortality (using data up to 2020, with adjustment for COVID impact) calculated by Office for National Statistics. Differences from previous analyses are attributable mainly toslowing pace of improvement in life expectancy, and also to slowing/stabilising increases in cancer incidence.

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49% of liver cancer cases in the UK are preventable.[1]

Liver cancer risk is associated with a number of risk factors.[2,3]

Liver Cancer Risk Factors

  Increases risk Decreases risk
'Sufficient' or 'convincing' evidence
  • Aflatoxins
  • Alcoholic drinks
  • Liver flukes (Clonorchis sinensis and Opisthorchis viverrini)
  • 1,2-Dichloropropane
  • Oestrogen-progestogen contraceptives
  • Hepatitis B and C viruses
  • Plutonium
  • Thorium-232 and its decay products
  • Tobacco smoking (in smokers and in smokers’ children)
  • Vinyl chloride
  • Body fatness
  
'Limited' or 'probable' evidence
  • Androgenic (anabolic) steroids
  • Arsenic and inorganic arsenic compounds
  • Betel quid without tobacco
  • DDT
  • Dichloromethane (Methylene chloride)
  • Human immunodeficiency virus (HIV) type 1
  • Schistosoma japonicum
  • Trichloroethylene
  • X-radiation, gamma-radiation
  • Coffee

International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classifications.

See also

Want to generate bespoke preventable cancers stats statements? Download our interactive statement generator.

More information about cancer risk factors evidence

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

Use our interactive tool to explore risk factors for liver cancer

 

 

References

  1. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018.
  2. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122*. Accessed October 2018.
  3. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed October 2018.
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International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] 20% of liver cancer cases in the UK are caused by smoking.[2]

Hepatocellular carcinoma (HCC) risk is 66% higher in current smokers, 51% higher in former smokers and around doubled in heavy smokers compared with never-smokers, a meta-analysis of cohort studies showed.[3] 

Hepatoblastoma risk is almost five times higher in children whose parents both smoked in the preconception period, a cohort study showed.[4]

UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

See also

See IARC's classifications on the role of this risk factor

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

View our statistics on tobacco and cancer

View our health information on smoking and cancer

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122*. Accessed October 2018.
  2. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018. 
  3. Abdel-Rahman O, Helbling D, Schöb O, et al. Cigarette smoking as a risk factor for the development of and mortality from hepatocellular carcinoma: An updated systematic review of 81 epidemiological studies. Journal of Evidence-Based Medicine 2017;10(4):245-254.
  4. Pang D, McNally R, Birch JM. Parental smoking and childhood cancer: results from the United Kingdom Childhood Cancer Study. BJC 2003;88:373-81.
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International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classify the role of this risk factor in cancer development.[1,2] 23% of liver cancer cases in the UK are caused by overweight and obesity.[3]

Liver cancer risk is 37% higher per 5-unit body mass index (BMI) increase, an umbrella study of meta-analyses showed.[4]

UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

See also

See IARC and WCRF's classifications on the role of this risk factor

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

View our statistics on obesity and cancer

View our health information on obesity, weight and cancer

References

  1. Lauby-Secretan B, Scoccianti C, Loomis D, et al. Body Fatness and Cancer--Viewpoint of the IARC Working Group. N Engl J Med. 2016 Aug 25;375(8):794-8.
  2. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed October 2018.
  3. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018.
  4. Kyrgiou M, Kalliala I, Markozannes G, et al. Adiposity and cancer at major anatomical sites: umbrella review of the literature. BMJ 2017;:j477.
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International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] 10% of liver cancer cases in the UK are caused by hepatitis B virus or hepatitis C virus infection.[2] An estimated 90% of liver cancer cases in developing countries, and 40% of cases in developed countries, are caused by hepatitis B or hepatitis C infection.[3]

Worldwide around 2 billion people are infected with hepatitis B virus, and around 80 million with hepatitis C virus.[4] Chronic infection occurs in around 10% (hepatitis B virus) and 80% (hepatitis C virus) of newly-infected people.[4]

Hepatocellular carcinoma (HCC) risk is around 20 times higher in people with hepatitis B virus and/or hepatitis C virus infection, in areas such as the UK where prevalence of infection is low.[5] HCC risk in people with hepatitis C virus infection is higher among those who are older, male, or have a previous alcohol-related hospital admission, a cohort study showed.[6]

80-90% of patients with hepatitis B virus- or hepatitis C virus-related HCC also have cirrhosis, but hepatitis B virus infection may also be associated with HCC risk in the absence of cirrhosis.[7,8]

Cholangiocarcinoma (CCA) risk is increased to a lesser extent with hepatitis B virus and/or hepatitis C virus infection.[9]

UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122. Accessed October 2018.
  2. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018.
  3. Parkin DM. The global health burden of infection-associated cancers in the year 2002. IJC 2006;118:3030-44.
  4. International Agency for Research on Cancer (IARC). World cancer report 2008. Lyon: IARC; 2008.
  5. Cho LY, Yang JJ, Ko KP, et al. Coinfection of hepatitis B and C viruses and risk of hepatocellular carcinoma: systematic review and meta-analysis. IJC 2011;128:176-84.
  6. McDonald SA, Hutchinson SJ, Bird SM, et al. A record-linkage study of the development of hepatocellular carcinoma in persons with hepatitis C infection in Scotland. BJC 2008;99:805-10.
  7. Donato F, Boffetta P, Puoti M. A meta-analysis of epidemiological studies on the combined effect of hepatitis B and C virus infections in causing hepatocellular carcinoma. IJC 1998;75:347-54.
  8. Adami HO, Hunter D, Trichopoulos D, eds. Textbook of Cancer Epidemiology. New York: Oxford University Press; 2002.
  9. Zhou Y, Zhao Y, Li B, et al. Hepatitis viruses infection and risk of intrahepatic cholangiocarcinoma: evidence from a meta-analysis. BMC Cancer 2012;12:289.
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International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classify the role of this risk factor in cancer development.[1,2] 7% of liver cancer cases in the UK are caused by alcohol drinking.[3] Almost one-third of liver cancer deaths in high-income countries are caused by alcohol.[4]

Liver cancer risk is 16% higher in people who consume 37.5g+ (4.5+ units) of alcohol per day, compared with non-drinkers, a meta-analysis showed.[5] Liver cancer risk is 2.2 times higher in people who consume 50g+ (6+ units) of alcohol per day, compared with non- or occasional drinkers, a meta-analysis showed.[6] Liver cancer risk is not associated with light or moderate  drinking (up to 4.5-6 units of alcohol per day), meta-analyses have shown.[5,6]

Hepatocellular carcinoma (HCC) risk among people with hepatitis B (HBV) or hepatitis C virus (HCV) infection is doubled in heavy drinkers compared with moderate or non-drinkers, a case-control study showed.[7]

Alcohol misuse is associated with cirrhosis, but may also cause liver cancer in the absence of cirrhosis.[5]

UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122*. Accessed October 2018.
  2. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed October 2018.
  3. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to known risk factors in England, Wales, Scotland, Northern Ireland, and the UK overall in 2015. British Journal of Cancer 2018.
  4. Danaei G, Vander Hoorn S, Lopez AD, et al. Causes of cancer in the world: comparative risk assessment of nine behavioural and environmental risk factors . Lancet 2005;366:1784-93.
  5. Turati F, Galeone C, Rota M, et al. Alcohol and liver cancer: a systematic review and meta-analysis of prospective studies. Ann Oncol 2014.
  6. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 2015 Feb 3;112(3):580-93.
  7. Donato F, Tagger A, Gelatti U, et al. Alcohol and hepatocellular carcinoma: the effect of lifetime intake and hepatitis virus infections in men and women. Am J Epidemiol 2002;155:323-31.
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Cirrhosis

Hepatocellular carcinoma (HCC) risk is 8-55 times higher in people with liver cirrhosis Open a glossary item, case-control and cohort studies show.[1-5] HCC risk is higher in HBV/HCV-related cirrhosis (accounting for 57% of cirrhosis cases worldwide[6,7]) than alcoholic cirrhosis.[8,9]

HCC risk is 19 times higher in people with a history of primary biliary cirrhosis, versus those without the condition, a meta-analysis showed.[10]

Cholangiocarcinoma (CCA) risk is ten times higher in people with cirrhosis, a case-control study showed.[10]

Non-alcoholic fatty liver disease (NAFLD)

Liver cancer risk is more than 4 times higher in people hospitalised with non-alcoholic fatty liver disease (NAFLD, related to obesity and diabetes[12]), compared with the general population, a cohort study showed.[13]

Gallstones

Liver cancer risk is 90% higher in people who have had gallstones (cholelithiasis), a meta-analysis of cohort studies showed.[14]

Diabetes

Liver cancer risk is more than tripled in people with type 1 diabetes, compared to people without type 1 diabetes a meta-analysis has shown.[15]

Hepatocellular carcinoma (HCC) risk is 66% higher in diabetics, a meta-analysis showed.[15] HCC risk among diabetics may be lower in metformin users, and higher in sulfonylurea or insulin users, each compared with non-users; but HCC risk is not associated with thiazolidinedione use, a meta-analysis showed.[16]

HCC risk may increase with duration of diabetes, a cohort study (mainly including men) showed.[17] HCC risk in diabetics appears to be independent of other liver cancer risk factors,[18-20] and diabetes is associated with further increased HCC risk in people with chronic liver disease, hepatitis C virus infection, or cirrhosis.[21]

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

References

  1. Franceschi S, Montella M, Polesel J, et al. Hepatitis viruses, alcohol, and tobacco in the etiology of hepatocellular carcinoma in Italy. Cancer Epidemiol Biomarkers Prev 2006;15:683-9.
  2. Randi G, Altieri A, Gallus S, et al. History of cirrhosis and risk of digestive tract neoplasms. Ann Oncol 2005;16:1551-5.
  3. La Vecchia C, Negri E, Cavalieri d'Oro L, et al. Liver cirrhosis and the risk of primary liver cancer. Eur J Cancer Prev 1998;7:315-20.
  4. Persson EC, Quraishi SM, Welzel TM, et al. Risk of liver cancer among US male veterans with cirrhosis, 1969-1996. BJC 2012;107:195-200.
  5. Fattovich G, Stroffolini T, Zagni I, et al. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology 2004;127:S35-50.
  6. Perz JF, Armstrong GL, Farrington LA, et al. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol 2006;45:529-38.
  7. Ribes J, Cleries R, Rubio A, et al. Cofactors associated with liver disease mortality in an HBsAg-positive Mediterranean cohort: 20 years of follow-up. IJC 2006;119:687-94.
  8. Persson EC, Quraishi SM, Welzel TM, et al. Risk of liver cancer among US male veterans with cirrhosis, 1969-1996. BJC 2012;107:195-200.
  9. Fattovich G, Stroffolini T, Zagni I, et al. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology 2004;127:S35-50.
  10. Liang Y, Yang Z, Zhong R. Primary biliary cirrhosis and cancer risk: a systematic review and meta-analysis. Hepatology 2012;56(4):1409-17
  11. Welzel TM, Graubard BI, El-Serag HB, et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population-based case-control study. Clin Gastroenterol Hepatol 2007;5:1221-8.
  13. Sorensen HT, Mellemkjaer L, Jepsen P, et al. Risk of cancer in patients hospitalized with fatty liver: a Danish cohort study. J Clin Gastroenterol 2003;36:356-9.
  15. Sona M, Myung S, Park K, et al. Type 1 diabetes mellitus and risk of cancer: a meta-analysis of observational studies. Japanese Journal of Clinical Oncology 2018;48(5):426-433.
  16. Singh S, Singh PP, Singh AG, et al. Anti-diabetic medications and the risk of hepatocellular cancer: a systematic review and meta-analysis. Am J Gastroenterol 2013;108(6):881-91; quiz 892.
  17. El-Serag HB, Tran T, Everhart JE. Diabetes increases the risk of chronic liver disease and hepatocellular carcinoma. Gastroenterology 2004;126:460-8.
  18. La Vecchia C, Negri E, Decarli A, et al. Diabetes mellitus and the risk of primary liver cancer. IJC 1997;73:204-7.
  19. Adami HO, Chow WH, Nyren O, et al. Excess risk of primary liver cancer in patients with diabetes mellitus. JNCI 1996;88:1472-7.
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Family history

Hepatocellular carcinoma (HCC) risk is 155% higher in people with a family history of liver cancer, a meta-analysis showed.[1]

Haemochromatosis

Hepatocellular carcinoma (HCC) risk is up to 11 times higher in people with haemochromatosis, compared with healthy controls, a meta-analysis showed.[2] The risk increase may be limited to specific haemochromatosis types,[2] and people with coexisting cirrhosis.[3]

References

  1. Yang Y, Wu QJ, Xie L, et al. Prospective cohort studies of association between family history of liver cancer and risk of liver cancer. Int J Cancer 2014;135(7):1605-14.
  2. Ellervik C, Birgens H, Tybjaerg-Hansen A, et al. Hemochromatosis genotypes and risk of 31 disease endpoints: meta-analyses including 66,000 cases and 226,000 controls. Hepatology 2007;46(4):1071-80.
  3. Kowdley KV. Iron, hemochromatosis, and hepatocellular carcinoma. Gastroenterology 2004;127:S79-86.
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International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1] Arsenic, polychlorinated biphenyls and trichloroethylene are classified by IARC as possible causes of liver cancer, based on limited evidence.[1] Less than 1% of liver cancer cases in the UK are caused by workplace exposures.[2]

UK portrait version shown here. Country versions, cancers caused by other risk factors, and landscape formats are available for free from our cancer risk publications.

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International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1]

An estimated 2,500 liver cancer cases worldwide each year are caused by liver flukes infection;[2] infection occurs mainly in endemic regions in China and other parts of Asia.[3-5]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122. Accessed October 2018.
  2. Parkin DM. The global health burden of infection-associated cancers in the year 2002. IJC 2006;118:3030-44.
  3. Sripa B, Kaewkes S, Sithithaworn P, et al. Liver fluke induces cholangiocarcinoma. PLoS Med 2007;4:e201.
  4. Shin HR, Oh JK, Masuyer E, et al. Epidemiology of cholangiocarcinoma: an update focusing on risk factors. Cancer Sci 2010;101:579-85.
  5. Gray DJ, Thrift AP, Williams GM, et al. Five-year longitudinal assessment of the downstream impact on schistosomiasis transmission following closure of the Three Gorges Dam. PLoS Negl Trop Dis 2012;6:e1588.
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International Agency for Research on Cancer (IARC) classifies the role of this risk factor in cancer development.[1]

Liver cancer risk is 5-6 times higher in people with HIV/AIDS, compared with the general population, meta-analyses have shown.[2,3] 

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 122. Accessed October 2018.
  2. Grulich AE, van Leeuwen MT, Falster MO, et al. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet 2007;370:59-67.
  3. Shiels MS, Cole SR, Kirk GD, et al. A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. J Acquir Immune Defic Syndr 2009;52(5):611-22.
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Coffee consumption is classified by the World Cancer Research Fund, American Institute for Cancer Research (WCRF/AICR) as probably protective against liver cancer.[1] 

Liver cancer risk is 48% lower in people with the highest intake of coffee, compared with the lowest intake of coffee, a meta-analysis showed.[2]

See also

Find out more about the definitions and evidence for this data

Learn how attributable risk is calculated

References

  1. World Cancer Research Fund / American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed October 2018.
  2. Godos J, Micek A, Marranzano M, et al. Coffee Consumption and Risk of Biliary Tract Cancers and Liver Cancer: A Dose–Response Meta-Analysis of Prospective Cohort Studies. Nutrients 2017;9(9):950.
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Cancer stats explained

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