Liver cancer is the third leading cause of cancer death in the world, surpassed only by lung cancer and female breast cancer. And unlike many other cancers, rates of liver cancer have increased alarmingly, 72% between 2003 and 2012, with liver cancer deaths increasing more than any other cancer. Most associate liver cancer with alcohol, and while there is certainly a strong link there, one lesser known risk factor that’s almost as easily prevented is infection from viral hepatitis.
Can Hepatitis Cause Liver Cancer?
Hepatitis can not only cause liver cancer, but it is the leading factor for a liver cancer diagnosis. According to the CDC, 65% of all liver cancer cases are related to a hepatitis infection.
Which Hepatitis Causes Liver Cancer?
There are several types of hepatitis—autoimmune hepatitis, and then five viral forms, hepatitis A, B, C, D and E. Autoimmune hepatitis is not catching, although previously having a viral form of hepatitis increases the risk for developing the autoimmune type. When doctors can’t identify which type of hepatitis a patient has, it’s called non-A-E hepatitis or hepatitis X. All forms of hepatitis cause liver damage, but only hepatitis B (HBV) and hepatitis C (HCV) are risk factors for liver cancer.
HCV is the most common blood-borne infection in the U.S., is a factor in 50% of all liver cancer cases, and also increases the risk for developing neck and head cancers and non-Hodgkin lymphoma.
How Does Hepatitis Cause Liver Cancer?
Hepatocellular carcinoma (HCC), or primary liver cancer, is often caused by scarring of the liver, called cirrhosis. Having a chronic hepatitis B or hepatitis C infection causes this scarring.
Can You Get Liver Cancer Without Hepatitis?
While having a chronic HBV or HCV infection is the most common risk factor for liver cancer, it is not the only one. In the United States, being a man, being an Asian-American or Pacific-Islander, having cirrhosis of the liver, having certain metabolic disorders, drinking excessive alcohol, smoking, being overweight, having type 2 diabetes, having certain rare diseases, or exposure to certain carcinogens all increase the risk of being diagnosed with liver cancer.
Can Liver Cancer Cause Hepatitis?
No. Liver cancer cannot cause a hepatitis infection.
How Do You Get Hepatitis B & C?
Hepatitis B and C share many of the same transmission methods—being exposed to infected blood (HCV/HBV) or infected bodily fluids (HBV). The most common ways to get infected include:
- Getting tattoos or piercings in unregulated settings with non-sterile equipment
- Having sex with an infected person
- Being born to an infected mother
- Having a blood transfusion or organ transplant before 1992, when screening became more widespread
- Sharing drug-injection equipment with an infected person
- Sharing personal items like razors, nail clippers, glucose monitors and toothbrushes with an infected person
- Being exposed to blood in an occupational setting
- Getting dialysis
- Living in a household of someone who is infected
Is Hepatitis Caused By Chemotherapy?
Chemotherapy treatment doesn’t cause hepatitis in those who have never had it, however, if you have been previously diagnosed with HBV, even if it has been treated, some types of chemotherapy may reactivate the hepatitis infection. If you plan on receiving chemotherapy for your cancer, talk to your doctor about being screened for hepatitis and beginning an antiviral therapy if you once had an infection.
Who is Most Affected by Hepatitis & Liver Cancer?
3.5 million Americans are living with chronic infections of HCV, leaving them at high risk for developing liver cancer. Of those, 81% are baby boomers, born 1945-1965 before the virus was discovered in 1989. Many boomers have been living with asymptomatic infections which have been slowly damaging their livers for years.
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In the U.S., both hepatitis B and liver cancer disproportionately affect Asian-Americans and Pacific Islanders. While these groups make up only 5% of our population, they account for 50% of all HBV infections.
American Hispanics, who have a 25-30% lower overall cancer rate than whites, have about two times the chance to be diagnosed with an infection-related cancer like liver cancer or cervical cancer.
What Can We Do?
With modern medical practices, in the United States Hepatitis B and C infections are almost entirely preventable. To reduce your exposure, practice safe sex, do not share personal, drug-injection or medical items, and always get piercings, tattoos, and other injections in sterile and regulated environments.
Get screened for hepatitis if you believe you’ve been exposed to it, plan to undergo chemotherapy or other immunosuppressive therapy, have HIV, are pregnant, are on dialysis, are an Asian-American, Pacific Islander, or boomer, or you were born in Asia, Africa or other area with a high rate of hepatitis.
If you haven’t been vaccinated against HBV, get vaccinated and if you are diagnosed with hepatitis, get treatment immediately. Delaying treatment may lead to chronic hepatitis, which is a main contributing factor in liver cancer.
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Sources
- “CDC Factsheet: Viral Hepatitis and Liver Cancer”, Centers for Disease Control and Prevention (CDC)
- “What is Viral Hepatitis?”, National Institute of Diabetes and Digestive and Kidney Diseases
- “Hepatitis B”, National Institute of Diabetes and Digestive and Kidney Diseases
- “Hepatitis C”, National Institute of Diabetes and Digestive and Kidney Diseases
- “Liver Cancer Risk Factors”, American Cancer Society
- “Hepatitis C and Liver Cancer: What To Know”, MD Anderson Cancer Center
- “Hepatitis C Questions and Answers For the Public”, Centers for Disease Control and Prevention (CDC)
- “Chemotherapy-related reactivation of hepatitis B infection: Updates in 2013”, World Journal of Gastroenterology, 2014
- “Hepatitis B Questions and Answers For the Public”, Centers for Disease Control and Prevention (CDC)
