- Hepatitis B carrier status
- Chronic hepatitis C infection
- Cirrhosis of almost any cause
- Hereditary hemochromatosis
- Environmental toxins (alfatoxin that commonly contaminates corn, soybeans and peanuts; contaminated drinking water; betel nut chewing)
- Tobacco and alcohol abuse
- Non-alcoholic fatty liver disease and diabetes mellitus
- Alpha-1 antitrypsin deficiency
- Epidermal growth factor polymorphisms
Also, it should be noted that HCC has been known to occur in patients without any identifiable risk factor.
For the coffee-lovers among us: several observational studies have implicated coffee consumption as a protective factor for liver cancer, including HCC. A meta-analysis estimated that consumption of two or more cups per day was associated with a 43% reduction of liver cancer. The benefit was observed in individuals with and without liver disease. The presumed mechanism surrounds the fact that coffee contains large amounts of antioxidants suggesting biological plausibility for the protective effect. The authors also noted that coffee and caffeine have been linked to lower liver enzyme levels and a reduced risk of cirrhosis, potentially further contributing to biological plausibility (Larsson SC, Wolk A. Coffee consumption and risk of liver cancer: a meta-analysis. Gastroenterology. 2007;132(5):1740)
