Risk factors and causes

We don’t know the exact cause of HCC. But certain things called risk factors can increase a person’s chance of developing it. Having one or more risk factors doesn’t mean you will get cancer, and not having a risk factor doesn’t guarantee you won’t. Being male and older are both risk factors for HCC. Other risk factors for HCC are:


Cirrhosis is scarring throughout the liver, which damages it and prevents it working properly. Cirrhosis increases the risk of HCC but only a small number of people with cirrhosis develop HCC. Cirrhosis can have different causes. These include: 

  • long-term infection with the hepatitis B or hepatitis C virus 
  • a high intake of alcohol over a long period of time 
  • conditions such as non-alcoholic fatty liver disease, haemochromatosis (a genetic condition) and primary biliary cirrhosis. These are described below.

Non-alcoholic fatty liver disease

This is when fat builds up in the liver and causes damage. This condition is more common in people who are very overweight (obese) or have Type 2 diabetes.


This is an inherited condition that causes iron levels to build up in the body. When it’s diagnosed and treated early, it doesn’t usually cause problems.

Primary biliary cirrhosis

This is a long-term condition that damages the small bile ducts in the liver.


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


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

Other risk factors

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

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

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

Back to Potential causes of cancer

Low immunity

People with low immunity are more likely to develop some types of cancer.

Viruses and bacteria

You can’t catch cancer from someone else. But some viruses may increase your risk of developing cancer.