Introduction

Liver cancer is the most frequently occurring cancer, and it is related to a high number of deaths. Although there have been significant advancements in cancer treatments, the outlook for liver cancer patients remains poor, particularly when the disease is diagnosed at a late stage.^{1, 2}  Liver cancer is of two types, primary and secondary liver cancer.³ Angiosarcoma and hepatoblastoma are considered rare kinds of liver cancer.⁴ Cholangiocarcinoma, hepatocellular carcinoma, mixed-type cancer, and hemangiocarcinoma are the various kinds of primary liver cancer, and 80 % of the liver cancer cases are of hepatocellular carcinoma. The occurrence of liver cancer has been gradually rising in various parts of the world, posing a major public health concern.¹

Risk factors of liver cancer

Some factors that can increase the risk of developing liver cancer are:

• Hepatitis B virus infection (HBV)
• Hepatitis C virus infection (HCV)
• Cirrhosis 
• Chronic ethanol use
• Use of nicotine 
• Aflatoxin B1 (a toxic mould that grows on food and can cause liver cancer if eaten in excess amounts)
• Nonalcoholic steatohepatitis (NASH)
• Untreated hereditary hemochromatosis
• Alpha-1 antitrypsin deficiency
• Glycogen storage disease
• Porphyria cutanea tarda (skin becomes very sensitive to sunlight, causing blisters)
• Wilson disease⁵

Prevention strategies for lung cancer

Prevention is necessary to decrease the incidence of liver cancer and deaths associated with liver cancer. Hence, priority should be given to the prevention of liver cancer.⁶

Preventing HBV and HCV infection

Globally, for liver cancer, HBV and HCV infections are considered important risk factors. These viral infections can transfer from person to person via unprotected sexual practice and contaminated needles, i.e. IV drug use. Some kinds of liver cancer can be prevented through safe sexual practices and avoiding needle sharing. 

These infections are also transmitted through blood transfusion. Hence, before any blood transfusion, the blood used for transfusion must be thoroughly screened for any contamination.   

Getting vaccinated against HBV infection

As recommended, every child and adult up to the age of fifty-nine, and also older individuals who are at risk of getting infected by HBV, should receive the HBV vaccine to decrease the risk of HBV infection and liver carcinoma. Identifying and avoiding the ways that HBV is transferred is the first step in preventing infection for those who have not yet received the vaccine.³

Checking for HBV and HCV

Individuals of eighteen years or older should be tested for HCV and HBV at least once, as recommended by the CDC.³

Reduced ethanol use

Liver cancer can be prevented by drinking alcohol in moderate quantities or by completely avoiding alcohol. ^3,5 

Quitting nicotine 

Cigarette smoking can lead to liver cancer, so individuals who smoke should try quitting smoking to reduce the risk of developing liver cancer.³ Quitting smoking without professional help can be risky, as it results in the development of withdrawal symptoms. 

Avoid aflatoxin B1

Avoiding the consumption of food products that contain aflatoxin B1 can reduce the chance of getting liver cancer.  

Maintaining a healthy weight 

Obese individuals are at greater risk of developing diabetes and fatty liver diseases, which are both linked to liver cancer. Hence, maintaining a healthy body weight reduces the chances of getting liver cancer.³ A healthy body weight can be maintained by following a healthy lifestyle and diet. 

Drugs associated with liver cancer prevention

Metformin, a common first-line drug for type 2 diabetes (T2D), has shown anticancer effects by reducing cell proliferation and inflammation in various experimental cancer models.

Statins, commonly used to treat hyperlipidemia and prevent cardiovascular events, also exhibit antitumor effects. Experimental studies suggest they have antiproliferative, proapoptotic, antiangiogenic, and immunomodulatory properties, primarily through inhibition of the mevalonate pathway and related mechanisms.⁷

Dietary products associated with liver cancer prevention

The most prevalent type of liver cancer, hepatocellular carcinoma (HCC), may be prevented by drinking coffee and green tea. Coffee is currently advised as part of liver health initiatives since it has been repeatedly associated with a lower risk of HCC. This advantage is linked to all varieties of coffee, including decaffeinated coffee, with the effects being more pronounced in people who consume more than three cups per day. Coffee may be beneficial because it lowers liver enzymes, reduces fibrosis and inflammation, and modifies pathways linked to cancer.

Green tea also exhibits potential, especially its antioxidant component EGCG. By reducing oxidative stress, stopping cell proliferation, and encouraging cancer cell death, EGCG decreases tumour growth in animal experiments. Additionally, it might help the immune system to fight cancer.⁷

Physical activity is associated with liver cancer prevention

Hepatocellular carcinoma (HCC) is one of the tumours in which physical activity may help lower the risk of acquiring. Higher levels of physical activity were associated with a decreased risk of HCC, according to a meta-analysis. Exercise may have preventive effects because it improves mitochondrial function, which lowers MASH activity, improves insulin sensitivity, and helps control the behaviour of cancer stem cells and communication pathways.⁷

Summary 

Liver cancer, particularly hepatocellular carcinoma (HCC), is a major global health concern with rising incidence and poor prognosis when diagnosed late. Key risk factors include HBV and HCV infections, cirrhosis, alcohol and tobacco use, aflatoxin B1 exposure, and obesity. Prevention strategies focus on HBV vaccination, safe practices to avoid viral transmission, regular screening, and lifestyle modifications. Drugs like metformin and statins show anticancer potential, while coffee and green tea consumption are linked to reduced HCC risk due to anti-inflammatory and antioxidant effects. Regular physical activity also lowers risk by improving insulin sensitivity and targeting cancer-related cellular pathways.