Liver cancer is the fifth-deadliest cancer for males

By Jennifer Welsh 

 Medically reviewed by Kashif J. Piracha, MD

The liver is the largest organ in your body. It works to break down and store nutrients, create fluids that help digestion, break down toxins, and make compounds that help blood clot.1

Liver cancer is the 13th most common cancer in the United States.2 It is the fifth-deadliest for males.3 It’s highly linked to chronic liver diseases, including hepatitis B and C and cirrhosis (liver scarring) from alcohol use disorder. 

When cells in the liver start to grow out of control, they can develop into liver cancer. Cancer is an abnormal growth of cells that can spread from one tissue to another and to other organs, eventually disrupting the body’s normal functioning.

Liver cancer was projected to make up about 2.2% of all new cancer cases in the United States in 2022, as well as about 5% of cancer deaths.4 This article will highlight important facts and statistics you should know about liver cancer.

Witthaya Prasongsin / Getty Images

Liver Cancer Overview

Liver cancer is a type of abnormal cell growth that starts in the liver but can spread throughout the body. Cells that have mutations (genetic changes) begin to grow and divide out of control, forming tumors, or lumps. The most common liver cancer in adults starts in the primary tissue of the liver and is called hepatocellular carcinoma (HCC).1

About 10%–20% of liver cancers start in the lining of the bile ducts inside the liver. These ducts are tubes that bring bile (a digestive liquid created in and released by the liver) to the gallbladder. Intrahepatic bile duct cancer (IBDC) is also called intrahepatic cholangiocarcinoma.5

The Surveillance, Epidemiology, and End Results Program (SEER) data used in this article includes cancer of the main liver tissue and IBDC. Together, they will be referred to as liver cancer. 

How Common Is Liver Cancer?

It was estimated that in 2022 there would be around 41,260 new cases of liver cancer in the United States. That’s 2.2% of all new cancer cases. About 30,520 deaths from liver cancer—about 5% of cancer deaths–were also predicted. A little over 100,000 people in the United States were living with liver cancer in 2019.4

Data from 2015 to 2019 show that about 9.5 out of every 100,000 people in the United States are diagnosed with liver cancer or IBDC every year. About 6.6 out of 100,000 will die from it. Over a lifetime, about 1.1% of all people will be diagnosed with liver cancer.4

From 1975 to 2005, liver cancer rates tripled in the United States.6 When looking at data between 2010 and 2019, the rate of new liver cancer diagnoses has been stable, though the death rates for liver cancer have been rising an average of 1.3% per year.4

Liver Cancer by Ethnicity and Gender

Males are more likely to get liver cancer. It is also more prevalent in Asian/Pacific Islander and American Indian/Alaskan Native populations.4

The table shows new cases of and deaths from liver cancer per 100,000 males, broken down by ethnicity. Data from the National Cancer Institute SEER database averaged from 2015 to 2019.

The table shows new cases of and deaths from liver cancer per 100,000 females, broken down by ethnicity. Data from the National Cancer Institute SEER database averaged from 2015 to 2019.

Liver Cancer by Age

Liver cancer, like most cancers, is more common the older you get.

Over a lifetime of exposure to toxic compounds in alcohol, diet, environment, and present in a person's body, the liver cells undergo genetic changes (mutations). The body's defenses against cancer also start to break down. Mutations build up and lead to cancerous cells that grow and spread in the liver.4

The table shows how many of the new cases and deaths from liver cancer fall into each age group. Data from the National Cancer Institute SEER database averaged from 2015 to 2019.

Causes of Liver Cancer and Risk Factors

Significant factors that increase someone’s risk for liver cancer are:7

• Chronic viral hepatitis: Most commonly hepatitis C and hepatitis B

• Cirrhosis: Most often due to alcohol use disorder in the United States 

Other factors that increase your risk of liver cancer include:

• Being male

• Nonalcoholic fatty liver disease (commonly caused by obesity)

• Primary biliary cirrhosis (caused by some autoimmune diseases)

• Inherited metabolic disorders, including hereditary hemochromatosis (a condition in which the body stores excess iron)

• Tobacco use

• Type 2 diabetes (a chronic disease of impaired ability to control blood sugar)

• Food contaminated with fungal toxin aflatoxin B1

Preventing the spread of viral diseases, decreasing alcohol and tobacco use, and reducing metabolic disease could prevent many liver cancer cases in the United States.8

What Are the Mortality Rates for Liver Cancer?

The five-year relative survival rate for liver cancer is 20.8%. That means about 20% of people diagnosed with liver cancer will be alive five years from diagnosis.4

Healthcare providers find many (about 44%) cases of liver cancer relatively early—while they’re still just in the liver. But even when it’s still localized, liver cancer has a five-year survival rate of 36.1%.

The survival rate gets worse the farther cancer has spread before being discovered. If it has spread to other tissues or lymph nodes in the area of the body where it started, it has a five-year survival rate of 12.8%. If it has already metastasized to distant locations, the five-year survival rate drops to 3.1%.4

The five-year survival rate for liver cancer has been steadily improving. From 1980 to 1995, the five-year survival rate for liver cancer was 5% to 6%. Starting around 1996, it increased at a steady clip.4

What Is the Survival Rate?

The survival rate is defined as the percentage of people who survive a disease such as cancer for a specified amount of time. This information may be presented in a number of different ways.

The number only reflects people diagnosed five or more years ago, so it doesn't reflect newer treatments. It cannot predict an individual's prognosis as that depends on individualized factors such as their state of overall health, the type of cancer, and whether and where it has spread.

Screening and Early Detection of Liver Cancer?

Catching liver cancer before it spreads can increase the likelihood of a positive outcome. But signs and symptoms of liver cancer do not show up until late-stage disease. Healthcare providers can't feel small tumors on a physical exam, and there are no widely recommended screening tests for liver cancer for people at average risk.9

People at a high risk of liver cancer include those who have cirrhosis, hereditary hemochromatosis, or chronic hepatitis. Healthcare providers may recommend that these people get an ultrasound of their liver—an imaging test that uses sound waves to produce images—every six months and a blood test to check their alpha-fetoprotein levels since high blood levels of this protein are a sign of liver cancer.

Some studies have reported that this screening approach could find liver cancer early, but experts don't know enough about the usefulness of this approach in improving outcomes.10

In addition, testing for diseases that can lead to liver cancer helps catch risk factors early and allows healthcare providers to prevent them from progressing. 

Summary

Liver cancer is not the most common type of cancer, but because it doesn’t come with many warning signs, it’s hard to detect early and has a high mortality (death) rate. Liver cancer rates can be reduced by limiting the spread of viral hepatitis, lowering the use and abuse of alcohol and tobacco, and reducing obesity and type 2 diabetes levels.

Sources

American Cancer Society. What is liver cancer? 

National Cancer Institute. Cancer statistics.

National Cancer Institute. Cancer stat facts: common cancer sites.

National Cancer Institute. Cancer stat facts: liver and intrahepatic bile duct cancer.

American Cancer Society. What Is Bile Duct Cancer? | What Is Cholangiocarcinoma? 

Shen Y, Risch H, Lu L, et al. Risk factors for hepatocellular carcinoma (HCC) in the Northeast of the United States: results of a case-control study. Cancer Causes Control. 2020;31(4):321-332. doi:10.1007/s10552-020-01277-1

American Cancer Society. Liver cancer risk factors.

American Cancer Society. Can liver cancer be prevented?

American Cancer Society. Can liver cancer be found early? 

Colli A, Nadarevic T, Miletic D, et al. Abdominal ultrasound and alpha-foetoprotein for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease. Cochrane Database Syst Rev. 2021;4(4):CD013346. doi:10.1002/14651858.CD013346.pub2

By Jennifer Welsh
Welsh is a Connecticut-based freelance science and health writer with a graduate certificate in science communication from UCSC.