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The information on this page was reviewed and approved by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on November 29, 2021.

Is there a link between cirrhosis and cancer?

The liver is one of your most hard-working organs, responsible for key jobs such as:

  • Producing vital proteins
  • Detoxifying your blood
  • Fighting infections
  • Aiding digestion

However, it’s not immune to damage when its workload becomes too great, and this damage can eventually lead to cancer.

What is cirrhosis?

If your liver suffers damage, its tissues can become scarred and stiff. When the amount of scarring is significant, affecting the entire organ and threatening its ability to function, the condition is called cirrhosis.

Liver scarring typically happens over many years. The most common culprits are serious alcohol misuse and chronic hepatitis infection, both of which can progressively harm the liver and cause scar tissue to form in the place of healthy tissue. Other causes of cirrhosis include a buildup of fat in the liver (fatty liver disease) and rare inherited conditions that alter its normal functioning. Cirrhosis affects about one in 400 adults in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

What’s more, a malfunctioning, scarred liver can trigger a cascade of problems and complications, including:

  • Kidney failure
  • Gallstones
  • Swollen veins in the esophagus, stomach or intestines
  • Internal bleeding from swollen veins
  • Fluid buildup in the abdomen

You’ve likely heard of the connection between cirrhosis and liver cancer. Cirrhosis is one of the strongest risk factors for liver cancer, meaning that people with cirrhosis are more likely to develop liver cancer than the general population. The reasons why cirrhosis can trigger liver cells to become cancerous are numerous and complex, but they likely have to do with inflammation and DNA damage that cause defective liver cells to multiply uncontrollably.

Though only a minority of people with cirrhosis will get liver cancer, people with cirrhosis make up most liver cancer cases. According to the National Cancer Institute (NCI), 70 percent to 90 percent of people with hepatocellular carcinoma (HCC), the most common form of liver cancer, also have cirrhosis. Estimates suggest that the risk of developing HCC among people with cirrhosis is between 5 percent and 30 percent during a five-year period, according to the NCI.

Research published in Clinical Gastroenterology and Hepatology found that 3 percent of people with cirrhosis developed liver cancer within the first year of their diagnosis, and about 1.3 percent developed liver cancer each year after that.

While the link between cirrhosis and liver cancer is well-established, there is also evidence that people with cirrhosis may be more at risk of developing cancers outside of the liver, including cancer of the:

However, it’s not clear that cirrhosis is a direct cause of non-liver cancers. The increased incidence of cancers in this population could have several explanations. Risk factors such as diabetes, obesity, smoking and alcohol abuse heighten the risk of many cancers and cirrhosis. As a result, the elevated cancer risk identified in patients with cirrhosis could be attributed to these shared risk factors, making it difficult to draw a direct link between cirrhosis and non-liver cancers.

Can cirrhosis be prevented?

Of the two main drivers of cirrhosis—hepatitis infection and alcohol abuse—hepatitis is more likely to cause liver cancer. One of two viruses is usually responsible for a hepatitis infection: hepatitis B virus (HBV) or hepatitis C virus (HCV). These are primarily spread through contact with hepatitis-infected blood, but they can also be passed through semen and other bodily fluids. Cirrhosis caused by HCV carries the highest risk of liver cancer, followed by HBV-related cirrhosis and alcohol-related cirrhosis.

Getting vaccinated to protect against HBV infection is an established method of cirrhosis and liver cancer prevention.

Your care team may also recommend lifestyle changes, such as:

  • Not drinking alcohol
  • Quitting smoking
  • Losing weight
  • Exercising regularly

Can cirrhosis be treated?

Treatment for cirrhosis may help slowly heal your liver and prevent complications such as cancer. Cirrhosis is treated differently based on the underlying cause.

For example, people with hepatitis-related cirrhosis may be given antiviral drugs. The drugs used for the hepatitis C virus are successful at eliminating the underlying infection, but it’s unclear how much they reduce the risk of liver cancer. Hepatitis B virus drugs have been shown to cut liver cancer risk by about 50 percent, according to the NCI.

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