What is HCC?

HCC (the short name for hepatocellular carcinoma), is a type of cancer that starts in the liver. It usually starts out as a small lump, called a tumor, and can grow larger over time. HCC doesn’t start all of a sudden. It usually starts slowly in a liver that’s been exposed to risk factors for HCC.

Risk Factors for HCC

  • Cirrhosis. Cirrhosis is, by far, the most important risk factor for HCC. In fact, HCC is rare in people without cirrhosis (except for those who have hepatitis B—see below). It doesn’t matter what caused the cirrhosis—cirrhosis from any cause, is a significant risk factor for HCC.
  • Hepatitis B. People with hepatitis B may develop HCC even if they haven’t progressed to cirrhosis.
  • Age. HCC is more common in people over the age of 60.
  • Alcohol. People who drink a lot of alcohol are at greater risk of developing liver cirrhosis. Liver cirrhosis is associated with an increased risk of HCC.
  • Ethnicity. In North America, HCC accounts for less than 1% of cancers. However, it’s more common in Africa, Southeast Asia, and China, where it may account for up to 50% of cancers.
  • Environmental risks. Vinyl chloride and thorium dioxide may increase the risk for getting HCC. People who eat food contaminated with aflatoxin, a mold that grows on peanuts and grains, are also at greater risk of developing HCC.
  • Gender. HCC is more common in men than in women.
  • Obesity. Obese people are at a greater risk of developing HCC than those who maintain a lower weight.
  • Smoking. Smoking increases the risk of getting HCC. Former smokers have a lowered risk than current smokers.
  • Other risks. Exposure to poisonous chemicals, toxins, radiation, and viruses can increase the risk of getting HCC. Defective genes and changes in genes are also risk factors.


In the early stage, HCC usually doesn’t cause any symptoms. This means that people can develop HCC and not know it right away.

If left untreated, over time people with HCC might experience:

    • Abdominal pain or swelling. Pain is in the right upper abdomen, which can travel to the right shoulder. The abdomen can also become swollen.
    • Itchy skin. This may occur if a tumor blocks the drainage of bile from the liver.
    • Jaundice. This is when the skin and eyes turn yellow. Often, there’s also a darkening of urine and a pale colour to the stool (bowel movement). This is because the tumor blocks the drainage of bile from the liver.
    • Liver pain. This occurs if the cancer is stretching the fibrous capsule that surrounds the liver. The liver doesn’t have nerve endings, so pain isn’t felt until the capsule is stretched.
    • Nausea, vomiting, or poor appetite. This may arise from the body’s reduced ability to eliminate toxins as well as changes in metabolism and digestion.
    • Weight changes. This can include weight loss for no known reason or weight gain in the form of water retention.


This material was adapted (with permission) from:

US Department of Veterans Affairs, Veterans Health Administration 

Canadian Liver Foundation


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