1. Viral Hepatitis: Strong association between viral hepatitis and liver cancer. 75% of liver cancer cases are attributed to either hepatitis B virus or hepatitis C virus. Vaccine is available for hepatitis B virus prevention but none for hepatitis C virus. Mode of spread of these viruses include injection drug use, unnprotected sex, childbirth, blood transfusion. Improved insight leads to decrease in viral transmission.
  2. Alcohol: Alcohol is strongly associated with liver cirrhosis and by itself chronic alcohol consumption has carcinogenic effect
  3. Chemical Carcinogens: Aflatoxin which is a product of aspergillus fungus found in a variety of stored grains particularly in hot and humid conditions. These grain can be seen to be covered with a white layer of aflatoxin.
  4.  Anabolic steroids used by some athletes to increase physical activity are also a predisposing factor for liver cancer
  5. Obesity: Excessive weight is also a factor implicated in causation of liver cancer. Regular physical activity and weight control is protective.
  6. Certain Inherited Metabolic disorders