Can People Without Hepatitis B Develop Liver Cancer?

While it's true that approximately 90% of liver cancer cases in China are linked to chronic hepatitis B infection, which can progress to cirrhosis and eventually liver cancer, it's also important to note that individuals who have never contracted hepatitis B can still develop this disease. The exact causes and mechanisms behind liver cancer are not yet fully understood, but several key risk factors have been identified that can contribute to liver cancer development in the absence of hepatitis B.

Alcohol Consumption and Dietary Factors

One of the most significant contributors is long-term heavy alcohol use, which can lead to alcoholic liver disease. Over time, this may progress to liver fibrosis and cirrhosis—conditions that significantly increase the risk of liver cancer. Additionally, consuming mold-contaminated foods or those containing nitrosamines, lacking essential trace elements, or being exposed to water contaminated with algal toxins have all been strongly associated with liver cancer development.

Environmental and Chemical Exposures

Exposure to certain toxins and chemicals has also been linked to liver cancer. Substances such as nitrosamines, nitrogen mustard compounds, and organochlorine pesticides are considered potential carcinogens to the liver. Furthermore, parasitic infections like schistosomiasis and clonorchiasis (caused by liver flukes such as Clonorchis sinensis) can increase the risk of developing cholangiocarcinoma and other liver malignancies.

Genetic and Ethnic Susceptibility

There is also evidence of a genetic component in liver cancer risk. Families with multiple cases of liver cancer suggest a possible hereditary predisposition. These patterns may be influenced by shared environmental factors, dietary habits, and living conditions. Moreover, liver cancer incidence varies across different ethnic populations, indicating that genetic susceptibility may play a role in some cases.

In summary, while hepatitis B remains a major cause of liver cancer, especially in endemic regions, it is not the only pathway. Awareness of other contributing factors—such as alcohol use, dietary habits, environmental toxins, and genetic predisposition—is crucial for prevention and early detection in individuals without hepatitis B infection.