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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65860_"><span class="title" itemprop="name">Liver (Hepatocellular) Cancer Prevention </span></h1><div class="subtitle">Patient Version</div><p class="small">Published online: May 15, 2024.</p><p class="small">Created: <span itemprop="datePublished">December 27, 2007</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000433423__257">This PDQ cancer information summary has current information about liver (hepatocellular) cancer prevention. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000433423__258">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Screening and Prevention Editorial Board.</p></div><div id="CDR0000433423__sm_CDR0000809688_20"><h2 id="_CDR0000433423__sm_CDR0000809688_20_">What Is Liver Cancer?</h2><p id="CDR0000433423__sm_CDR0000809688_22">Primary liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver. Cancer that forms in other parts of the body and spreads to the liver is not primary liver cancer. The liver is one of the largest organs in the body. It has two lobes and fills the upper right side of the abdomen inside the rib cage. The main functions of the liver include the following:</p><ul id="CDR0000433423__sm_CDR0000809688_23"><li class="half_rhythm"><div>to make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046508/" class="def">bile</a> to help digest fat that comes from food</div></li><li class="half_rhythm"><div>to store glycogen (sugar), which the body uses for energy</div></li><li class="half_rhythm"><div>to filter harmful substances from the blood so they can be passed from the body in stools and urine</div></li></ul><div id="CDR0000433423__sm_CDR0000809688_24" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20liver&p=BOOKS&id=603833_CDR0000658698.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65860/bin/CDR0000658698.jpg" alt="Anatomy of the liver; drawing shows the right and left lobes of the liver. Also shown are the bile ducts, gallbladder, stomach, spleen, pancreas, small intestine, and colon." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the liver. The liver is in the upper abdomen near the stomach, intestines, gallbladder, and pancreas. The liver has a right lobe and a left lobe. Each lobe is divided into two sections (not shown). </p></div></div><div id="CDR0000433423__sm_CDR0000809688_25"><h3>Types of liver cancer</h3><p id="CDR0000433423__sm_CDR0000809688_26"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046363/" class="def">Hepatocellular carcinoma</a> and <a href="https://www.cancer.gov/types/liver/bile-duct-cancer/treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">bile duct cancer (cholangiocarcinoma)</a> are the main types of adult primary liver cancer.</p><p id="CDR0000433423__sm_CDR0000809688_28">Most adult primary liver cancers are hepatocellular carcinomas. This type of liver cancer is the third leading cause of cancer-related deaths worldwide.</p><p id="CDR0000433423__sm_CDR0000809688_29">Primary liver cancer can occur in both adults and children. However, treatment for children is different than treatment for adults. For more information, see <a href="https://www.cancer.gov/types/liver/childhood-liver-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Childhood Liver Cancer</a>.</p></div><div id="CDR0000433423__sm_CDR0000809688_30"><h3>Signs and symptoms of liver cancer</h3><p id="CDR0000433423__sm_CDR0000809688_31">These and other signs and symptoms may be caused by adult primary liver cancer or by other conditions. Check with your doctor if you have any of the following:</p><ul id="CDR0000433423__sm_CDR0000809688_17"><li class="half_rhythm"><div>a hard lump on the right side just below the rib cage</div></li><li class="half_rhythm"><div>
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discomfort in the upper abdomen on the right side</div></li><li class="half_rhythm"><div>a swollen abdomen</div></li><li class="half_rhythm"><div>
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pain near the right shoulder blade or in the back</div></li><li class="half_rhythm"><div>jaundice
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(yellowing of the skin and whites of the eyes)</div></li><li class="half_rhythm"><div>easy bruising or bleeding</div></li><li class="half_rhythm"><div>unusual tiredness or weakness</div></li><li class="half_rhythm"><div>nausea and vomiting</div></li><li class="half_rhythm"><div>loss of appetite or feelings of fullness after eating a small meal</div></li><li class="half_rhythm"><div>weight loss for no known reason</div></li><li class="half_rhythm"><div>pale, chalky <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651179/" class="def">bowel movements</a> and dark urine</div></li><li class="half_rhythm"><div>fever</div></li></ul></div></div><div id="CDR0000433423__sm_CDR0000809692_42"><h2 id="_CDR0000433423__sm_CDR0000809692_42_">Liver Cancer Causes, Risk Factors, and Prevention</h2><p id="CDR0000433423__sm_CDR0000809692_43">Worldwide, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044242/" class="def">liver cancer</a> is the sixth most common cancer and the third leading cause of cancer death. In the United States, rates are highest in American Indian or Alaska Native individuals. Liver cancer is the sixth leading cause of cancer deaths in the United States.</p><div id="CDR0000433423__sm_CDR0000809692_3"><h3>Liver cancer causes and risk factors</h3><p id="CDR0000433423__sm_CDR0000809692_35">The most common type of liver cancer in adults, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046363/" class="def">hepatocellular carcinoma</a> (HCC), typically develops in people with chronic (long-lasting) liver disease caused by hepatitis virus <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a> or cirrhosis. Men are more likely to develop HCC than women. People with multiple risk factors have an even higher risk.</p><p id="CDR0000433423__sm_CDR0000809692_31">Many risk factors have been associated with liver cancer. Not everyone with one or more of these risk factors will develop the disease, and the disease will develop in some people who don’t have any known risk factors. Risk factors include the following:</p><ul id="CDR0000433423__sm_CDR0000809692_7"><li class="half_rhythm"><div class="half_rhythm"><b>Hepatitis B virus (HBV) infection</b>: HBV can be transmitted in blood, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046703/" class="def">semen</a>, or other body fluids. The infection can be passed from mother to child during childbirth, through sexual contact, or by sharing needles that are used to inject drugs. It can cause inflammation (swelling) of the liver that leads to cancer. Routine HBV <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045937/" class="def">vaccination</a> in infancy is reducing the incidence of HBV infection. Chronic HBV infection is the leading cause of liver cancer in Asia and Africa.</div></li><li class="half_rhythm"><div class="half_rhythm"><b>Hepatitis C virus (HCV) infection</b>: HCV can be transmitted in the blood. The infection can be spread by sharing needles that are used to inject drugs or, less often, through sexual contact. In the past, it was also spread during <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045991/" class="def">blood transfusions</a> or organ <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046631/" class="def">transplants</a>. Today, blood banks test all donated blood for HCV, which greatly lowers the risk of getting the virus from blood transfusions. It 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.</div></li><li class="half_rhythm"><div class="half_rhythm"><b>Cirrhosis</b>: The risk of developing liver cancer is increased for people who have cirrhosis, a disease in which healthy liver <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> is replaced by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000640078/" class="def">scar tissue</a>. The scar tissue blocks the flow of blood through the liver and keeps it from working as it should. Chronic <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000450090/" class="def">alcoholism</a> and chronic hepatitis infections are common causes of cirrhosis. People with HCV-related cirrhosis have a higher risk of developing liver cancer than people with cirrhosis related to HBV or alcohol use.</div></li><li class="half_rhythm"><div class="half_rhythm"><b>Heavy alcohol use</b>: Heavy alcohol use can cause cirrhosis, which is a risk factor for liver cancer. Liver cancer can also 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 with heavy alcohol users who do not have cirrhosis.</div><div class="half_rhythm">Studies have shown there is also an increased risk of liver cancer in people with HBV or HCV infection who use alcohol heavily.
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</div></li><li class="half_rhythm"><div class="half_rhythm"><b>Aflatoxin B1</b>: The risk of developing liver cancer may be increased by eating foods that contain aflatoxin B1 (poison from a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044571/" class="def">fungus</a> that can grow on foods, such as corn and nuts, that have been stored in hot, humid places). It is most common in sub-Saharan Africa, Southeast Asia, and China.</div></li><li class="half_rhythm"><div class="half_rhythm"><b>Nonalcoholic steatohepatitis (NASH)</b>: NASH is a condition that can cause cirrhosis that may lead to liver cancer. It is the most severe form of nonalcoholic fatty liver disease, where there is an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> amount of fat in the liver. In some people, this can cause inflammation and injury to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> of the liver.</div><div class="half_rhythm">Having NASH-related cirrhosis increases the risk of developing liver cancer. Liver cancer has also been found in people with NASH who do not have cirrhosis.
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</div></li><li class="half_rhythm"><div class="half_rhythm"><b>Cigarette smoking</b>: 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.</div></li><li class="half_rhythm"><div class="half_rhythm"><b>Other conditions</b>: Certain rare medical and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046391/" class="def">genetic</a> conditions may increase the risk of liver cancer. These conditions include the following:
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<dl id="CDR0000433423__sm_CDR0000809692_22" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">untreated <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797037/" class="def">hereditary hemochromatosis</a></p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797046/" class="def">alpha-1 antitrypsin deficiency</a></p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748984/" class="def">glycogen storage disease</a></p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797043/" class="def">porphyria cutanea tarda</a></p></dd><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000797039/" class="def">Wilson disease</a></p></dd></dl>
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</div></li></ul></div><div id="CDR0000433423__sm_CDR0000809692_23"><h3>Liver cancer prevention</h3><p id="CDR0000433423__sm_CDR0000809692_36">Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.</p><p id="CDR0000433423__sm_CDR0000809692_37">Anything that increases your chance of getting cancer is called a risk factor. Anything that lowers your chance of getting cancer is called a cancer protective factor. Prevention includes avoiding risk factors and increasing protective factors.</p><p id="CDR0000433423__sm_CDR0000809692_38">The following are protective factors for liver cancer:</p><ul id="CDR0000433423__sm_CDR0000809692_24"><li class="half_rhythm"><div><b>Getting the hepatitis B vaccine</b>: Preventing HBV infection (by being <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044841/" class="def">vaccinated</a> for HBV as a newborn) has been shown to lower the risk of liver cancer in children. It is not yet known if being vaccinated lowers the risk of liver cancer in adults.</div></li><li class="half_rhythm"><div><b>Getting treatment for chronic hepatitis B infection</b>: Treatment options for people with chronic HBV infection include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045324/" class="def">interferon</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000460201/" class="def">nucleos(t)ide</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044919/" class="def">analog</a> therapy. These treatments may reduce the risk of developing liver cancer.</div></li><li class="half_rhythm"><div><b>Reducing exposure to aflatoxin B1</b>: Replacing foods that contain high amounts of aflatoxin B1 with foods that contain a much lower level of the poison can reduce the risk of liver cancer.</div></li></ul></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65860</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389299" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389299</a></span></div></div></div>
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