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Causes include:

  • in 80% of cases there is some existing liver cirrhosis: major cause in developed world is pre-existing alcoholic liver cirrhosis.
  • other causes of primary liver cancer include:
    • chronic HBV or HCV carriage
    • cirrhosis of any cause but especially alpha-1 antitrypsin deficiency, haemochromatosis, primary biliary cirrhosis
  • drugs such as anabolic steroids and the contraceptive pill
  • toxins such as aflatoxin - a toxin produced by species of Aspergillus which grows on stored grains and peanuts
  • parasitic infestations for example, schistosomiasis, echinococcus, clonorchis sinensis

10 to 15% of all types of cirrhosis develop hepatocellular carcinoma in 20 years; 35% if the cirrhosis is caused by haemochromatosis or alcohol.

Last reviewed 08/2021