Liver cancer is due to excessive proliferation of tumor cells, cells with dysregulated replication mechanisms that eventually take over the liver’s healthy cells. In adults, the most common type of liver cancer is hepatocellular carcinoma (HCC).
Liver cancer can be classified into 3 types:
- Primary liver cancer occurs when the primary tumor originates from the hepatobiliary system. Some examples include hepatocellular carcinoma, bile duct cancer (intrahepatic cholangiocarcinoma); and rarer forms of cancer such as angiosarcoma, hemangiosarcoma, hepatoblastoma, and fibrolamellar carcinoma.Secondary liver cancer (metastatic liver cancer) occurs when the tumor originates from another part of the body and spreads to the liver, either by hematogenous (blood circulation) or through lymphatic system.
- The last group of liver cancers include benign liver tumors such as hemangioma, hepatic adenoma, and focal nodular hyperplasia (FNH). These Are non-cancerous in nature and usually need monitoring or rarely, surgery because of pain, discomfort or mass effect (pushing on stomach or bile ducts).
Stages of Liver Cancer: There are different liver cancer staging systems; These staging systems are not used uniformly among physicians. The one most commonly used liver cancer staging system in the United States is the AJCC (American Joint Committee on Cancer) TNMsystem. This staging system uses 3 pieces of information:
- Tumor size (T): How large is the cancer? Is there more than one liver tumor?
- Lymph node involvement (N): Has the cancer reached nearby lymph nodes?
- Tumor spread (metastasis; M): Has the cancer spread to nearby or distant lymph nodes, organs, or bones?
The primary risk factors of liver cancer:
- Viruses, including hepatitis B virus (HBV) (the third leading cause of cancer deaths in the world) and hepatitis C virus (HCV)cirrhosis/end stage liver diseasealcohol consumptionmetabolic dysfunction-associated steatotic liver disease (MASLD)metabolic dysfunction-associated steatohepatitis (MASH); some of the risk factors for MASH include diabetes and obesitygenetic/inherited liver diseasesexposure to some toxinssteroid usehemochromatosis (condition where the body stores more iron than it needs),
- other causes
Globally, up to 80 percent of liver cancers are caused by hepatitis B (HBV) or hepatitis C virus (HCV).
Risk factors for liver cancer:
- Cirrhosis (scarring of the liver) from any cause (including chronic hepatitis B or C,
- Metabolic dysfunction-associated steatotic liver disease (MASLD)
- Metabolic dysfunction-associated steatohepatitis (MASH)
- Alcohol-associated liver disease (ALD)
- Met+ALD (metabolic with alcohol-associated liver disease)
- Hereditary hemochromatosis (iron overload disorder)
- Alpha 1 antitrypsin deficiency
- Primary biliary cirrhosis (PBC)
- Male gender
- Being a member of certain racial/ethnic groups
- Obesity
- Older age
- Tobacco use
- Type 2 diabetes (T2D)
- Steroid use
- HIV/AIDS
- Exposure to certain toxins/substances (e.g., aflatoxins (poisons produced by crop molds), vinyl chloride and thorium dioxide (thorotrast)
- Family history of liver cancer
- Certain rare diseases
- Other factors
Chronic viral hepatitis is a leading cause of liver cancer in the US.
Bile duct cancer (cholangiocarcinoma) occurs in the bile ducts, which are the tubes or channels that carry bile that’s produced by the liver and helps with several important functions. Bile ducts drain the bile made in the liver to the gallbladder and small intestine.
There are two types of bile duct cancer based on where they originate:
- Intrahepatic bile duct cancer (intrahepatic cholangiocarcinoma’s): This type forms in the ducts inside the liver. Only a small number of bile duct cancers are intrahepatic, and the survival rate is very low.
- Extrahepatic bile duct cancer: This type forms in the ducts outside the liver. There are two types of extrahepatic bile duct cancer: perihilar bile duct cancer (Klatskin tumor, perihilar cholangiocarcinoma) and distal bile duct cancer (extrahepatic cholangiocarcinoma).
Prevalence of liver cancer: an estimated 108,247 people were living with liver and intrahepatic bile duct cancer in the US (2021).
Incidence (new cases) of liver and intrahepatic bile duct cancer: 9.4 per 100,000. (2017–2021).
New cases of liver/bile duct cancer (2024, estimated): 41,630 (2.1% of all new cancer cases).
Liver/bile duct cancer deaths (2024, estimated): 29,840 (4.9% of all cancer deaths for the year).
5-Year liver and intrahepatic bile duct cancer survival rate: 22% (2013-2019);21.7% (2014–2020).
Liver cancer carries poor prognosis.
Liver cancer is rare compared to other cancers, making up only around 2% of all cancers in the United States. However, it accounts for about 4.8% of all cancer deaths in the country. The most common type of liver cancer is hepatocellular carcinoma (HCC). During the past few decades, the incidence and mortality of liver cancer has rapidly increased in the US. However, since 2017, the incidence rate has been declining, and the death rate has stabilized. That being said, liver cancer is still considered to have one of the worst survival rates, with an average five-year survival rate of 21.6%.
Worldwide, liver cancer is the sixth most common cancer and the third leading cause of cancer-related deaths.
In the US, “liver and intrahepatic bile duct cancer” is the sixth leading cause of cancer deaths.
The US liver cancer death rates:
- 5.30 per 100,000 (2021)
- 6.6 per 100,000 (2018–2022)
Liver cancer is the 13th most common type of cancer overall in the U.S., with 41,630 estimated new (incident) cases (28,000 men; 13,630 women) and 29,840 estimated deaths (19,120 men; 10,720 women) in 2024.
Globally, more than 800,000 people are diagnosed with liver cancer each year.
Liver cancer is more common in sub-Saharan Africa and Southeast Asia than in the US. In fact, it is the most common type of cancer in those regions.
Worldwide, liver cancer is a leading cause of cancer deaths, with more than 700,000 deaths each year.
The rates of liver cancer are higher in Southwestern and Southeastern areas of the US, which have the highest populations of Black and Hispanic people.
Liver cancer is one of the most rapidly growing causes of cancer related deaths in the U.S.
Liver cancer death rates have more than doubled since 1980.
Liver cancer incidence rates have more than tripled since 1980.
In some cases, even though the rate is going down, the number of new cases and deaths is going up. This is due to aging and increase in the population size.
Liver cancer/hepatocellular carcinoma (HCC) is more common in men than women.
In the US, Asian/Pacific Islander people have the highest liver cancer rates, followed by Hispanic/Latino, American Indian/Alaska Native, African American/Black, and White peoples.
In the US, liver cancer incidence and mortality are approximately 1.5X to 2X higher in American Indian/Alaska Native (AIAN), Asian American, African American/Black, and Hispanic/Latino people than in the White people.
American Indian/Alaska Native men were almost 2X as likely to have liver and intrahepatic bile duct (IBD) cancer as non-Hispanic White men. (2014-2018)
American Indian/Alaska Native women are 2.3 X more likely to have liver and intrahepatic bile duct (IBD) cancer, and 2.2 X as likely to die from those diseases as non-Hispanic White women. (2014-2018)
In the US, liver cancer incidence (new cases) is higher among African American/Black people, compared to White people. (2017–2021)
African American/Black women are 30% more likely to die from liver/intrahepatic bile duct (IBD) cancer than non-Hispanic White women. (NCI 2022 Cancer Rates (2015-2019 data))
African American/Black men are 60% more likely to get and die from liver/intrahepatic bile duct (IBD) cancer than non-Hispanic White men. (NCI 2022 Cancer Rates (2015-2019 data))
During 2000–2019: the liver cancer mortality rate was highest in American Indian/Alaska Native people (10.5 deaths per 100,000), followed by Asian (7.5/100,000), African American/Black (7.6/100,000), and Hispanic/Latino (7.7/100,000) peoples, and was lowest for the White population (5.5/100,000).
The population with the highest liver cancer mortality rate changed from Asian people (2000) to American Indian/Alaska Native people (2019).
Liver cancer deaths among US males, ranked by demographic group as follows (2018–2022):
- Non-Hispanic American Indian/Alaska NativeHispanic/LatinoNon-Hispanic African American/BlackNon-Hispanic Asian/Pacific Islander
- Non-Hispanic White (NHWs)
Liver cancer deaths among US females, ranked by demographic group as follows (2018–2022):
- Non-Hispanic American Indian/Alaska Native
- Hispanic/Latino
- Non-Hispanic Asian /Pacific Islander
- Non-Hispanic African American/Black
- Non-Hispanic White (NHWs)
Incidence and mortality rates of liver and bile duct cancer (HCC/ICC) increased during 1975-2017, particularly in males, non-Hispanic African American/Black people, and older people.
A recent (2023) summary of Surveillance Epidemology and End Results Program (SEER)* data (2021) of liver/IBD cancer found the following racial/ethnic trends:
- Compared to non-Hispanic Whites (NHWs) (7.3%), all other racial/ethnic populations had higher liver cancer.
- American Indian/Alaskan Native (AI/AN) people had the highest rates (17.8%), then Hispanic/Latino (14%), Asian American, Native Hawaiian/Pacific Islander (AANHPI) (10.6%), and African American/Black (9.5%) peoples.
*The Surveillance, Epidemiology, and End Results Program (SEER), run by the National Cancer Institute, provides information on cancer incidence and mortality in different demographics.
Liver disease/liver cancer disproportionately affect certain groups: marginalized racial/ethnic, low socioeconomic status (SES), and other populations experiencing health disparities. Evidence ties social determinants of health (SDoH) to liver disease/cancer in people experiencing health disparities.
Food insecurity may be linked to the development of MASLD, one of the risk factors for liver cancer.

Last updated on December 11th, 2025 at 10:41 am

Liver Cancer