Since 1980, the U.S. incidence of liver cancer has tripled and the death rate has doubled.

“Excess weight, nonalcoholic fatty liver disease, and diabetes are greatly contributing to higher rates of liver cancer in the U.S.,” says Katherine McGlynn, senior investigator in the metabolic epidemiology branch at the National Cancer Institute.

It’s not clear how they might increase risk, but it is clear that they are all linked.

“Excess weight increases fat storage in the liver and the risk of insulin resistance and type 2 diabetes,” says McGlynn.

And those changes are linked to inflammation, which can cause scarring.

“There’s a whole cascade of pathology,” explains McGlynn. “Inflammation can lead to liver disease, starting with scarring and progressing all the way to cirrhosis.”

More factors that raise or lower your risk

Heavy drinking and smoking are also risk factors. On the plus side, coffee may protect your liver.

Coffee (regular or decaf) is linked to a lower risk of liver cancer.

“Coffee has been associated with a decreased risk in study after study,” says McGlynn. “The decrease is seen with both caffeinated and decaffeinated, suggesting that an ingredient other than caffeine is providing the protection.”

Do you need a hepatitis C test?

Since 2012, the Centers for Disease Control and Prevention (CDC) has advised all baby boomers—anyone born between 1945 and 1965—to get a hepatitis C test.

“The virus circulated in the blood supply until 1992,” says McGlynn.

“Before then, anyone who had a blood transfusion or other medical encounter in which they came in contact with blood could have become infected with the virus. And many infections have no symptoms, so people might never know they were infected.”

If you do have hepatitis C (an inflammation of the liver), it can be cured.

“The drugs are expensive,” says McGlynn, “but more insurance companies are covering them because the high price is still cheaper than paying for the long-term consequences.”

You have a higher risk of liver cancer if you:

  • have chronic hepatitis B or C infection
  • have excess weight
  • have type 2 diabetes
  • are a heavy drinker
  • smoke tobacco

Warning signs of liver cancer:

  • bulge or hard lump below rib cage on right side
  • abdominal pain or swelling
  • yellow skin or whites of eyes
  • loss of appetite
  • unintended weight loss
  • weakness
  • fever