What Causes Primary Liver Cancer?

Primary liver cancer is most commonly associated with cirrhosis following chronic hepatitis. In China, approximately 90% of liver cancer patients have a history of Hepatitis B virus (HBV) infection. The main progression pathway involves HBV infection leading to chronic hepatitis, then cirrhosis, and eventually liver cancer. This mechanism is predominant in the development of hepatocellular carcinoma. In Western countries, Hepatitis C virus (HCV) infection is more prevalent and follows a similar progression pathway to liver cancer. Some individuals may even develop liver cancer during the chronic hepatitis stage, before cirrhosis occurs.

Other Contributing Factors to Liver Cancer

In addition to viral hepatitis, several other risk factors are linked to the development of liver cancer. Dietary and lifestyle habits play a significant role. Long-term excessive alcohol consumption can lead to alcoholic liver disease, which may progress to liver fibrosis and eventually cirrhosis — all of which increase the risk of liver cancer. Individuals infected with HBV or HCV who also consume alcohol regularly may experience a faster progression of liver damage, significantly raising the likelihood of developing liver cancer.

Diet and Environmental Influences

Consuming moldy or nitrosamine-contaminated food over long periods has also been associated with liver cancer. Diets lacking essential trace elements and drinking water contaminated with algal toxins may further increase the risk. Exposure to certain chemicals such as nitrosamines, azo dyes, and organochlorine pesticides is also considered potentially carcinogenic to the liver.

Parasitic Infections and Liver Cancer

Parasitic infections like schistosomiasis and clonorchiasis (caused by liver flukes such as Clonorchis sinensis) are also known to contribute to liver cancer development. These infections can cause chronic inflammation and structural damage to the liver, increasing the likelihood of malignant transformation.

Genetic and Racial Predispositions

The occurrence of liver cancer within families may be due to both genetic susceptibility and shared environmental or lifestyle factors such as diet and living conditions. Additionally, liver cancer incidence varies among different ethnic populations, suggesting that race and ethnicity may also influence risk. Understanding these various factors is essential for prevention and early detection of liver cancer.