Risk factors are the inherited or acquired factors that increase the chance of developing cancer in a person. Several epidemiological studies have suggested a number of genetic and environmental factors that may predispose to liver cancer. A knowledge about them helps us to make necessary lifestyle choices.
- Hepatitis B/C infection: Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) is the well-recognized major risk factor for the liver cancer development.
HBV is responsible for high incidences of liver cancer in Asia and Africa, while HCV is responsible for the high incidences of the disease in Europe, Japan, and North America. Alcohol intake may act synergistically with these infections and can further increase the risk of developing liver cancer.
- Liver cirrhosis: Patients with liver cirrhosis remain at high risk of developing liver cancer. The cirrhosis may result from any of the following cause: excessive alcohol intake, chronic liver injury, inherited error of metabolism (for example, hemochromatosis – a condition characterized by increased absorption of iron due to mutation in HFE gene), Wilson’s disease, schistosomiasis (infection caused by a blood fluke), or alpha-1 anti-trypsin deficiency. All these disorders have been reported to be the independent risk factor for liver cancer development.
- Metabolic disorders: Many studies have suggested that the presence of certain metabolic disorders like obesity, diabetes, impaired glucose metabolism, and non-alcoholic fatty liver is associated with increased risk of developing liver cancer.
- Environmental exposure: Exposure to aflatoxin (produced by Aspergillus fungus that commonly contaminates peanuts, wheat, soybeans, groundnuts, corn, and rice), arsenic or microcystin in drinking water, vinyl chloride, and thorium dioxide have also been reported to increase the risk of liver cancer development.
- Individuals with prolonged use of anabolic steroid are generally at higher risk of developing liver cancer.
- Male gender: Liver cancer is about 2 to 3 times more common in men compared to women, worldwide. This disparity is postulated to be related to the differential effect of androgen on the hepatocytes.
- Ethnicity: According to different epidemiological studies, incidences of liver cancer are highest in Asians followed by African Americans and then Caucasians.
Chronic cigarette/tobacco smoking and prolonged use of oral contraceptives are some less important risk factor for the development of liver cancer.
In the next section, you will read about the symptoms of liver cancer.
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