Causes and risk factors of liver cancer

Certain risk factors can increase a person’s chance of developing primary liver cancer.

What are risk factors?

We do not know the exact cause of liver cancer (HCC). But certain things called risk factors can increase a person’s chance of developing it. Having one or more risk factors does not mean you will get cancer. And if you do not have any risk factors, this does not mean you will not get cancer.

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HCC is more common as people get older. Most people diagnosed are over 65.


HCC is more common in men than in women.


People who smoke tobacco have a much higher risk of HCC than non-smokers.

Hepatitis infection

Long-term infection with the hepatitis B virus (HBV) or hepatitis C virus (HCV) can cause HCC.


People who have cirrhosis have a higher risk of getting HCC. Cirrhosis is scarring all over the liver. It damages the liver and stops it working properly.

The risk factors for cirrhosis include:

  • Alcohol
    Drinking too much alcohol over a long period of time can cause cirrhosis. We have more information about alcohol and drinking guidelines.
  • Non-alcoholic fatty liver disease
    This is when fat builds up in the liver and causes damage to the liver.
  • Hepatitis B or C
    Long-term infection with hepatitis B or hepatitis C can cause cirrhosis.
  • Haemochromatosis
    This is an inherited condition that causes iron levels to build up in the body. When it is diagnosed and treated early, it does not usually cause problems.
  • Primary biliary cirrhosis (also called primary biliary cholangiopathy)
    This is when the body’s immune system, which normally fights infection, slowly destroys the small bile ducts in the liver.


People with type 2 diabetes have a higher risk of developing HCC.

Metabolic syndrome

Metabolic syndrome is a group of conditions that occur together.

They include:

  • high blood pressure
  • high blood sugar
  • high levels of unhealthy fats (triglycerides) in the blood
  • extra fat around the tummy area (abdomen).

People with metabolic syndrome have a higher risk of developing HCC.

Family history

Having a close family member (father, mother, sister or brother) with primary liver cancer increases a person’s risk. Doctors are not sure why this is.

Other risk factors

Anabolic steroids taken over a long time slightly increase the risk of HCC. These are mainly used by bodybuilders.

A poison called aflatoxin, found in mouldy peanuts and grains, is a major risk for HCC in parts of Africa and Asia.