Modifiable risk factors related to liver cancer | Knowledge for policy

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Modifiable risk factors related to liver cancer as described by health-related organisations

Effect of alcohol consumption on liver cancer risk
World Cancer Research Fund 2018
There is strong evidence that consuming approximately three or more alcoholic drinks a day is a cause of liver cancer
World Health Organization 2007
Alcohol use is a risk factor for many cancer types including liver cancer
American Cancer Society 2019
Alcohol consumption is known to cause cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colon, rectum and female breast.
National Cancer Institute 2023
Heavy alcohol use can cause cirrhosis, which is a risk factor for liver cancer. Liver cancer can occur in heavy alcohol users who do not have cirrhosis. Heavy alcohol users who have cirrhosis are ten times more likely to develop liver cancer, compared to heavy alcohol users who do not have cirrhosis.

Effect of smoking on liver cancer risk
World Cancer Research Fund 2018
‘Smoking increases the risk of liver cancer generally, but there is a further increase in the risk among smokers who also have the hepatitis B or hepatitis C virus infection and also among smokers who consume large amounts of alcohol’
National Cancer Institute 2023
‘Cigarette smoking has been linked to a higher risk of liver cancer. The risk increases with the number of cigarettes smoked per day and the number of years the person has smoked’
American Cancer Society 2019
‘Smoking increases the risk of liver cancer. People who smoked and stopped have a lower risk than those who still smoke, but both groups have a higher risk than those who have never smoked’

Effect of diet and nutrition on liver cancer risk
World Cancer Research Fund 2018
There is strong evidence that drinking coffee is linked to a decreased risk of liver cancer. Higher consumption of coffee probably protects against liver cancer. There is limited evidence that higher consumption of fish decreases the risk of liver cancer

Effect of body weight/adiposity on liver cancer risk
Nordic Nutrition Recommendations 2023
“There is convincing evidence for a causal association between high BMI and [...] an increased risk of cancer in oesophagus (adenocarcinoma), pancreas, liver, colon, breast (at postmenopausal age), endometrium and kidney.”
World Cancer Research Fund 2018
There is strong evidence that having overweight or obesity (assessed by body mass index) is a cause of liver cancer ‘Greater body fatness (marked by BMI) is a convincing cause of liver cancer’
American Cancer Society 2019
Obesity increases the risk of developing liver cancer. This is probably because it can result in fatty liver disease and cirrhosis

Effect of food contaminants on liver cancer risk
World Cancer Research Fund 2018
There is strong evidence that consuming food contaminated by aflatoxins (toxins produced by certain fungi) is a cause of liver cancer. Higher consumption of aflatoxin-contaminated foods are convincing causes of liver cancer.

Effect of physical activity level on liver cancer risk
World Cancer Research Fund 2018
There is limited evidence that physical activity decreases the risk of liver cancer

Effect of medication use on liver cancer risk
World Cancer Research Fund 2018
Long-term use of oral contraceptives, containing high doses of oestrogen and progesterone, is an established cause of liver cancer
American Cancer Society 2019
‘Anabolic steroids are male hormones used by some athletes to increase their strength and muscle mass. Long-term anabolic steroid use can slightly increase the risk of hepatocellular cancer’

Effect of infections on liver cancer risk
European Centre for Disease Prevention and Control (Hepatitis B and Hepatitis C)
“Individuals with chronic HBV infection are at a higher risk of complications including liver cirrhosis (25%) and cancer (5%)”. “Hepatitis C is a major cause of liver cancer. Without treatment, up to 30% of people with chronic hepatitis C develop liver damage in the form of cirrhosis, and some of them may develop liver cancer”.
World Cancer Research Fund 2018
Hepatitis B and hepatitis C viruses are causes of liver cancer. Chronic viral hepatitis is a cause of liver cancer. Infestation with liver flukes is a cause of cholangiocarcinoma.
National Cancer Institute 2023
Hepatitis B virus (HBV) infection (that can be transmitted in blood, semen, or other body fluids, can be passed from mother to child during childbirth, through sexual contact, or by sharing needles) can cause inflammation (swelling) of the liver that leads to cancer. Chronic HBV infection is the leading cause of liver cancer in Asia and Africa. Hepatitis C virus (HCV) infection (that can be spread by sharing needles, or less often, through sexual contact) can cause cirrhosis that may lead to liver cancer. Chronic HCV infection is the leading cause of liver cancer in North America, Europe and Japan.

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