Liver Cancer: Risks, Prevention and Screening to Protect Liver Health

Liver cancer is one of the most preventable yet fatal forms of cancer worldwide. Nearly up to 80 percent of primary liver cancers are because of chronic viral hepatitis B or C, conditions that inflame and scar the liver over years. Understanding your risk factors, adopting preventive lifestyle changes, and getting regular screenings can help detect liver cancer early, when it’s most treatable.

The liver is a vital organ responsible for detoxifying harmful substances, aiding digestion, and regulating metabolism. When its cells undergo genetic mutations, they may grow uncontrollably, forming malignant tumors.

There are two main categories:

• Primary liver cancer: Starts in the liver (most commonly hepatocellular carcinoma [HCC]).
• Secondary/metastatic liver cancer: Spreads to the liver from other organs (such as colon, lung, or breast).

Worldwide, hepatocellular carcinoma remains the most frequent type and is commonly associated with hepatitis B, hepatitis C, fatty liver disease or cirrhosis.

Chronic Hepatitis B and C Infections

Up to 4 in 5 cases of liver cancer stem from hepatitis B or C infections.

• Hepatitis B (HBV): Transmitted through blood, unprotected sex, or from mother to child during childbirth. Vaccination can prevent it.

• Hepatitis C (HCV): Spread mainly via infected blood, shared needles, or unscreened transfusions (especially before 1994). There’s no vaccine yet, but it’s curable with antiviral drugs.

Both viruses can silently damage the liver over 20–30 years, leading to cirrhosis and eventually cancer.

A rapidly growing epidemic in India and worldwide, NAFLD occurs when excess fat (triglycerides) accumulates in liver cells.

It is most common among people who are:

• Overweight or obese
• Diabetic or insulin-resistant
• Living a sedentary lifestyle
  

When untreated, NAFLD can progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and liver cancer.

• Excessive alcohol consumption remains a leading cause of cirrhosis and hepatocellular carcinoma.
• Those who consume alcohol and also have hepatitis B or C face a multiplied risk of liver cancer.
• Avoiding or limiting alcohol is crucial for individuals with any liver condition.
  

This uncommon hereditary condition leads to the body absorbing too much iron, which builds up in the liver and other organs and ultimately results in cancer and fibrosis. Damage can be avoided with early diagnosis via blood tests.

• Aflatoxins: Produced by molds on improperly stored grains, nuts, and spices, especially in warm, humid regions.
• Arsenic: Sometimes found in contaminated groundwater.
• Vinyl chloride: A chemical used in plastics manufacturing.
• Anabolic steroids: Long-term use can elevate risk.

The good news is that most causes of liver cancer are preventable. Simple but consistent lifestyle choices and medical precautions can drastically reduce your risk.

Prevent Hepatitis B and C Infections

Vaccination for Hepatitis B

• The hepatitis B vaccine is safe, effective, and provides > 95 % protection.
• It’s included in most childhood immunization schedules.
• Adults who haven’t received it, especially healthcare workers or those at higher risk, should get vaccinated.

Prevent Hepatitis C Transmission

• Avoid sharing needles or razors.
• Ensure all blood transfusions are from screened donors.
• Use barrier protection during sexual activity.
• Verify sterilization for tattoos, piercings, and dental tools.

If you test positive for hepatitis B or C, early antiviral treatment can stop liver scarring and significantly lower your cancer risk.

Obesity increases liver fat, insulin resistance, and inflammation.

Adopt a lifestyle that includes:

• Regular exercise (at least 30 minutes daily)
• A diet rich in fruits, vegetables, and whole grains
• Limited processed foods, sugar, and saturated fats

These habits help prevent NAFLD and other metabolic conditions linked to liver cancer.

• Avoid moldy or improperly stored grains and nuts to prevent aflatoxin exposure.
• Eat fresh, balanced meals with high fiber content.
• Stay hydrated.
• Limit red meat and refined carbohydrates.
• Choose lean proteins and heart-healthy fats (olive oil, avocados, nuts in moderation).
  

• People diagnosed with hepatitis B or C should remain under regular medical supervision.
• Antiviral therapies can reduce viral load, prevent cirrhosis, and lower cancer risk.
• Manage diabetes, high cholesterol, or thyroid issues early, they can worsen NAFLD progression.

Liver cancer develops slowly, often over two to three decades. In its early stages, symptoms are minimal or absent, which makes routine screening essential, especially for those at higher risk.

Who Should Be Screened?

You should consider regular screening if you:

• Have chronic hepatitis B or C
• Have cirrhosis from any cause
• Are overweight, diabetic, or have NAFLD
• Have a family history of liver disease

Ultrasound

A simple, non-invasive imaging test to detect liver nodules or abnormalities. It is recommended every 6 months for high-risk individuals.

Alpha-Fetoprotein (AFP) Blood Test

Liver cells produce a protein called AFP. Increased levels could be a sign of cancer or liver damage. For better accuracy, it is frequently used in combination with ultrasound.

CT scan or MRI

If ultrasound or AFP results are suspicious, advanced imaging can provide detailed visualization and guide further management.

Regular screening allows for early diagnosis, when curative treatments like surgery, ablation, or transplantation are still possible.

• Eat a diet rich in antioxidants (berries, leafy greens, turmeric).
• Avoid crash diets and fad cleanses that stress the liver.
• Get adequate sleep and manage stress to maintain immune balance.
• Avoid unnecessary medications or supplements that can harm the liver.
• Quit smoking, it’s an independent risk factor for liver cancer.
  

Seek medical attention if you experience:

• Persistent fatigue or weakness
• Pain in the right upper abdomen
• Jaundice (yellowing of eyes/skin)
• Unexplained weight loss
• Swelling of the abdomen (ascites)
• Loss of appetite

These could indicate advanced liver disease or developing cancer. Early intervention can save lives.