LIVER CANCER
RISK FACTORS

doctor touching hand

Some people have underlying reasons why they are more likely to get a disease than the average person — these are called risk factors. There are a number of potential risk factors for liver cancer. Some risk factors, such as smoking, are lifestyle choices. Others, such as your ethnicity, aren't under your control. Understanding risk factors may improve conversations with a doctor about managing liver cancer risk. Below are some of the most common risk factors; this list is not comprehensive. Talk with your doctor about the risk factors that may be most relevant to you.

UNDERLYING MEDICAL CONDITIONS

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Hepatitis B virus (HBV) and hepatitis C virus (HCV)
In the United States, hepatitis B and C are the most common forms of hepatitis and can lead to liver cancer; 850,000 Americans are estimated to be living with HBV, and 2.4 million are estimated to be living with HCV. Most don’t realize that they are infected.

Both of these forms of hepatitis are spread by contact with an infected person’s blood. HBV was often transmitted to an infant from an unknowing mother before HBV vaccines were common. Prior to 1992, hepatitis C could be spread by an organ donation or a blood transfusion.


Regardless of how HBV or HCV was contracted, getting screened and following up with a doctor are important to treating liver disease. Chronic hepatitis that goes unmanaged can result in cirrhosis and liver cancer. Talk to your doctor about whether you should get screened for hepatitis B and hepatitis C.
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Cirrhosis
Cirrhosis is when scar tissue replaces healthy liver cells. It has several causes, including chronic hepatitis B or C and drinking too much alcohol. Cirrhosis increases your chance of developing liver cancer.
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Diabetes
Chronic medical conditions such as diabetes and obesity increase the risk of liver cancer. Work with your doctor if you have diabetes with the goal of managing your blood sugar levels and achieving a healthy body weight.
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Non-alcoholic fatty liver disease (NAFLD)
NAFLD is the most common chronic liver condition in the United States — in fact, 25% of Americans are affected by it. NAFLD is caused by an accumulation of fat in the liver, and it is a risk factor for liver cancer.

LIFESTYLE

Smoking
Smoking
Cigarette smoking has been associated with a significant increase in the development of liver cancer. For those who smoke, work with your doctor to quit smoking to improve your overall health, as well as potentially reduce your risk for liver cancer.
drinking

Drinking more than moderate amounts of alcohol
Drinking a lot of alcohol can lead to cirrhosis, which raises the risk for liver cancer. For those who drink alcohol, the Centers for Disease Control and Prevention (CDC) recommends moderate amounts — no more than 1 drink a day for women and 2 for men.

ETHNICITY

Asian Americans and liver cancer

Asian man

If you are Asian American or Pacific Islander, you may be at higher risk for liver cancer. There are several reasons for this, but hepatitis B is the most common one.

It’s important to note that hepatitis B, which is spread by contact with an infected person’s blood, is different from hepatitis A, which is spread by consuming food or water that has been contaminated with hepatitis A.

There is a higher incidence of hepatitis B in the United States among those born in countries with a high prevalence of chronic hepatitis B, such as countries in Asia and the Pacific Islands.

In the United States, over 860,000 people are living with chronic hepatitis B, and over 50% are Asian American or Pacific Islander.

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Your liver’s relationship to hepatitis B (HBV)
Chronic hepatitis B can lead to inflammation and damage to the liver, called cirrhosis. A majority of patients with cirrhosis of the liver develop liver cancer.

Although there is currently no cure for the HBV infection, closely managing it can lower your risk for cirrhosis and liver cancer.

HBV can be passed down from mother to child. If you were born in a country with a high prevalence of HBV, or were born in the United States before 1991 when the HBV vaccine became widely available, consider asking your doctor to screen you for HBV. If you were never vaccinated against HBV and have never been tested for the virus, you may be at risk. This is important because it’s possible to be infected and not know it.

Ask your doctor if you should be screened for HBV, and partner with your doctor to manage HBV if you’re positive for the virus.

Asian American liver cancer risk factors — beyond HBV
HBV is a significant risk factor for Asian Americans. But there are others to consider:

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Diabetes
According to the Centers for Disease Control and Prevention (CDC), Asian Americans have the highest proportion (50%) of undiagnosed diabetes. Diabetes can increase the risk of liver cancer. It’s important to work closely with your doctor to manage your diabetes. Your doctor may prescribe medication and recommend diet and exercise.

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Smoking — quitting may be easier with help
Smoking is linked to an increase in the likelihood of liver cancer. Quitting smoking is an action you can take for your health. For those who smoke, talk to your doctor, as there are many resources to help you quit smoking.

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Alcohol — drink moderately
Heavy drinkers are 5 times more likely to develop liver cancer. The Centers for Disease Control and Prevention (CDC) recommends no more than 1 drink a day for women and 2 for men.

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Aflatoxin exposure
Some Asians who have immigrated to the United States came from countries where exposure to poisons called aflatoxins is a problem. Exposure to aflatoxins is associated with an increased risk of liver cancer. Aflatoxins are produced by molds that grow on plant products, such as peanuts, grains, or corn.

Consuming meat or dairy products from animals that ate contaminated feed can also lead to exposure. In the United States, there have been no reported outbreaks of human illness as a result of aflatoxins; however, in developing countries, this has been a problem.

Hispanics and Liver Cancer

Hispanic man

Any family can experience disruption and pain when an illness like liver cancer affects one of its own. In the Hispanic population, liver cancer is twice as likely to occur, as opposed to in non-Hispanic whites. Why is this? Here are some of the most common risk factors and some ways you can work with your doctor to manage them.

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Diabetes
Hispanics in the United States are twice as likely to develop type 2 diabetes than non-Hispanic whites. What’s more, they are likely to develop it earlier and have more complications. Work with your doctor to manage your diabetes.

  • Commit to regular checkups, at least once a year or as recommended by your doctor. Find a doctor you can communicate with, or bring a family member or friend with you to help you communicate with your doctor
  • Get your whole family involved in learning about healthy eating and exercise habits. This can help you stick with a new diet or exercise routine, as well as help your children, who are also at higher risk for type 2 diabetes, to adopt healthy habits. Talk to your doctor before starting a new exercise program or making dietary changes
  • If your doctor prescribes insulin for your diabetes, take it as directed. When working with your doctor to manage diabetes, it’s very important that you take each medicine you’re prescribed as directed by your doctor
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Fatty liver disease — the epidemic you’ve never heard of
Non-alcoholic fatty liver disease — or NAFLD for short — is caused by a combination of obesity, diabetes, and other factors. Studies have shown that nearly half of Hispanics live with this condition, which is described as excess fat being stored in the liver.

NAFLD affects more than 80 million Americans and is the most common cause of chronic liver disease in the country. It is seen more often in Hispanics than other ethnic groups. Fatty liver disease is a problem because it can lead to liver cancer.

Despite how common this condition is in Hispanics, there are a number of actions that can be taken to lower risk for fatty liver disease and liver cancer. Talk to your doctor to learn more about fatty liver disease and how to manage it.

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Obesity — make a plan to maintain a healthy body weight
Being overweight is linked to liver cancer. Work with your family and your doctor to put together a plan you can really commit to, aimed at getting your weight under control.

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Diet — embrace a healthier way of eating
Speak to your doctor about making mindful changes to your diet to potentially decrease the severity of fatty liver disease and help reduce risk for diabetes.

  • Adopting a low-glycemic diet rich in plant-based foods (fruits, vegetables, whole grains, nuts, and legumes) and fish has been shown to be effective in reducing liver fat, even if it doesn’t reduce overall body weight
  • Lower your consumption of red meats and high-fat dairy products, and only drink alcohol in moderation, such as a glass of red wine with a meal
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Hepatitis C (HCV) — a curable infection
One reason that liver cancer is so high among Hispanics is the number of hepatitis C virus infections. Older Hispanics may have gotten HCV as a result of an organ donation or a blood transfusion. It’s also possible to get HCV through other means, such as sexual contact with an infected person or sharing needles.

No matter how someone might get an HCV infection, it’s important to realize 2 things:

  1. An HCV infection could lead to liver damage and, from there, liver cancer
  2. HCV is treatable — and may be curable; getting diagnosed and treating HCV can help lower your risk for liver cancer
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Never share needles
Sharing of contaminated intravenous (IV) needles raises the risk for HCV infection, and HCV can lead to liver cancer.

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Alcohol — drink moderately
Drinking a lot of alcohol can lead to cirrhosis, which raises your risk for liver cancer. For those who drink alcohol, commit to only moderate amounts. The Centers for Disease Control and Prevention (CDC) recommends no more than 1 drink a day for women and 2 for men.

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Smoking — quitting may be easier with help
Smoking is linked to an increase in the likelihood of liver cancer. Quitting smoking is an action you can take for your health. For those who smoke, talk to your doctor, as there are many resources to help you quit smoking.

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Aflatoxin exposure
Some Hispanics who have immigrated to the United States came from countries where exposure to poisons called aflatoxins is a problem. Exposure to aflatoxins is associated with an increased risk of liver cancer. Aflatoxins are produced by molds that grow on plant products, such as peanuts, grains, or corn.

Consuming meat or dairy products from animals that ate contaminated feed can also lead to exposure. In the United States, there have been no reported outbreaks of human illness as a result of aflatoxins; however, in developing countries, this has been a problem.

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What is LENVIMA?

It is not known if LENVIMA is safe and effective in children.

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What is LENVIMA?

  • LENVIMA is used by itself as the first treatment for a type of liver cancer called hepatocellular carcinoma (HCC) when it cannot be removed by surgery

It is not known if LENVIMA is safe and effective in children.

Important Safety Information

LENVIMA may cause serious side effects, including:

  • high blood pressure (hypertension): High blood pressure is a common side effect of LENVIMA and can be serious. Your blood pressure should be well controlled before you start taking LENVIMA. Your healthcare provider should check your blood pressure regularly during treatment with LENVIMA. If you develop blood pressure problems, your healthcare provider may prescribe medicine to treat your high blood pressure
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