Liver cancer is relatively rare overall. Around 2 out of every 100 (2%) of all cancers diagnosed yearly in the UK are liver cancers. But that includes bile duct cancer and other very rare types of liver cancer. So HCC is even rarer than that.
There are factors that we know increase your risk of developing HCC, but some people don’t have any of them. In 1 in 4 cases (25%) we don’t know what causes it. Doctors call this ‘sporadic cancer’.
Fibrolamellar HCC is a type of liver cancer that is more often diagnosed in teenagers and young adults. Doctors haven’t yet found what causes it.
It’s a bit of a myth that liver cancer is always related to drinking alcohol. In fact, in the UK fewer than 1 in 10 cases of HCC (9%) are diagnosed in people with existing liver disease caused by drinking.
Who gets HCC?
Most people diagnosed with HCC in the UK are older, with 7 out of 10 cases diagnosed in people over 65. Most types of cancer are more common in older people, because there has been more time for their body cells to collect damage. DNA mistakes (mutations) can happen by chance when cells are dividing, or because the body has been exposed to something that damages cells, such as a virus, alcohol or cigarette smoke.
Every year in the UK, there are around 2,800 cases of HCC diagnosed in men and fewer than 800 diagnosed in women. So it’s around 4 times as common in men than it is in women.
Risk factors for HCC
Although we don’t know what causes some cases, most are related to having another type of long term (chronic) liver disease.
More than 9 out of 10 (90%) cases of HCC are related to cirrhosis, which means scarring. Your doctor may call this fibrosis because the working liver tissue is replaced by fibrous tissue. The scarred liver tissue can no longer work properly so over a long period, your liver capacity becomes less and less.
A lot of people automatically think of alcohol when they hear the word ‘cirrhosis’. Of course, it can be related to alcohol, but it has many other causes. Worldwide, 85 out of 100 (85%) HCC cases are caused by chronic infection with a hepatitis virus. Other causes include other liver diseases, such as haemochromatosis and primary biliary cholangitis.
Read more about cirrhosis on the main British Liver Trust website.
If you have cirrhosis you should be offered regular checks for liver cancer. You can find out more about these here.
Viral hepatitis infection
The types of hepatitis virus linked to HCC are hepatitis B and C. These are chronic infections that cause liver damage over a long period of time. Around 1 in 3 people with hepatitis C will eventually develop HCC but this can be many decades after they were infected. Drinking alcohol when you have hepatitis can double your risk of HCC.
Read about viral hepatitis on the British Liver Trust main website.
Some people with hepatitis B will be offered regular checks for liver cancer. You can find out more about these here.
Although HCC is not necessarily caused by drinking alcohol, it does increase risk, leading to almost 1 in 10 cases in the UK. People who have liver disease caused by alcohol are at around 5 times the risk of developing HCC as people in general.
Being overweight and diabetes
There is a condition called fatty liver disease that is associated with obesity, diabetes and resistance to insulin (the hormone that controls blood sugar levels). Like cirrhosis, fatty liver disease can lead to HCC. Because of this, people with diabetes have a slightly increased risk of developing HCC.
Having HCC in your family
If you have a close relative who’s had HCC, you are more at risk of it yourself. A close relative means a parent, brother, sister or child. The increase in risk is 2½ times that of people in general. Although that sounds a lot, do remember that the overall risk of HCC in the general population is low. An increased risk of a rare disease can still be a small risk overall.
There may be some gene faults linked to HCC, although researchers are yet to identify any specific mutations. Some rare inherited liver diseases have a higher risk of HCC.
As with many cancer types, HCC is more likely in smokers. Given HCC’s rarity, this isn’t a large increase in risk.
Content last reviewed: October 2022
Next review date: October 2025