Liver Cancer Awareness Month Highlights Rising Cases, Shift in Causes

October 1, 2026

By Tammy McCausland

Liver cancer is relatively rare in the United States, making up only about 2 percent of the total new cancer cases diagnosed here in 2026.¹ But an important message for October’s Liver Cancer Awareness Month is that, compared to many other types of cancer, liver cancer diagnoses are on the rise, with cases in the United States tripling over the last 40 years.² Adding to the concern over primary liver cancer is its status as the world’s third-leading cause of cancer-related deaths.³ Between 2016 and 2022, American liver cancer patients saw only a 21.9 percent five-year relative survival rate.¹

What’s more, recent research points to a shift in underlying causes that’s more highly pronounced in the Americas, Europe and Asia. Widespread adoption of the hepatitis B vaccine and the advent of effective antiviral treatments for hepatitis C are helping to block the viral hepatitis infections that, along with liver damage from cirrhosis, previously were the most common factors behind primary liver cancer diagnoses. Now, metabolic conditions including obesity, type 2 diabetes, and metabolic dysfunction-associated steatohepatitis (formerly known as nonalcoholic steatohepatitis, or NASH) are factoring into an increasing share of the liver cancer caseload.⁴

Early detection of any cancer offers more treatment options and better outcomes, but symptoms and other signs of liver cancer—among them jaundice, unexplained weight loss, nausea, fever, and pain in the abdomen or near the right shoulder blade—typically aren’t noticeable until the disease reaches later stages. Blood tests and ultrasound exams are recommended mainly for people at higher risk of developing liver cancer, among them people with cirrhosis or chronic hepatitis B infections, but the results may not be definitive.⁵

One potentially promising development for earlier detection is a liquid biopsy platform that uses artificial intelligence to analyze blood samples for DNA fragments and other biomarkers that point to the presence of cancer.⁶ Developed by researchers at Johns Hopkins Medicine, the tool builds on earlier work focused on lung cancer and spun off into the California-based DELFI Diagnostics Inc.

The shift toward liver cancers associated with metabolic conditions underscores the importance of avoiding smoking, reducing alcohol consumption, maintaining a healthy weight through exercise and a nutritious diet, and adopting other practices that reduce the likelihood of developing these known risk factors. One recent study linked regular consumption of sugar-sweetened drinks to a higher chance of developing hepatocellular carcinoma, the single most common form of primary liver cancer, although the researchers couldn’t determine a similar direct correlation in their data to beverages containing aspartame and other artificial sweeteners.⁷ Both types of sweetened drinks, however, have been associated with weight gains and diabetes.

Another potential link under investigation is exposure to per- and polyfluoroalkyl substances (PFAS). Also known as “forever chemicals,” these synthetic compounds used in products ranging from nonstick cookware to stain-resistant fabrics and firefighting foams break down slowly in the environment, where they accumulate in the bodies of living creatures, including people. Previous research suggests that some of these compounds may spur cancer-related changes in liver cells. In March 2026, the National Institutes of Health awarded a $3.4 million grant to scientists at the University of Southern California to look into PFAS as a risk factor for hepatocellular carcinoma.⁸

“We have been studying the effects of PFAS for years, particularly in relation to metabolic diseases such as obesity, diabetes, and liver disease,” Vaia Lida Chatzi said in a news release announcing the grant. “It is becoming increasingly apparent that these chemicals may also play a role in the development of cancers.” Chatzi, a professor of population and public health sciences and pediatrics at USC’s Keck School of Medicine, is one of the study’s principal investigators.

With primary liver cancer projected to impact more people in the coming decades—one forecast indicates a roughly 55 percent increase in new diagnoses as well as deaths worldwide between 2020 and 2040⁹—these messages about the disease’s changing risk factors take on greater urgency.

References

1. National Cancer Institute Survival, Epidemiology, and End Results Program. “Cancer Stat Facts: Liver and Intrahepatic Bile Duct Cancer.” Accessed October 1, 2026.
2. American Cancer Society. “Key Statistics About Liver Cancer.” Accessed October 1, 2026.
3. Adra S, Alabrach Y, Hashem A, et al. “Trends of primary liver cancer incidence and mortality in the United States: A population-based study over the last four decades.” PLoS ONE. 2024; https://doi.org/10.1371/journal.pone.0309465
4. Huang DQ, Singal AG, Kono Y, et al. “Changing global epidemiology of liver cancer from 2010 to 2019: NASH is the fastest growing cause of liver cancer.” Cell Metabolism. 2022; https://doi.org/10.1016/j.cmet.2022.05.003
5. American Cancer Society. “Can Liver Cancer Be Found Early?” Accessed October 1, 2026.
6. Orjuela H, Norton C, Koul S, et al. “Detection and characterization of hepatocellular carcinoma using cfDNA fragmentomes.” Cell Press Blue. 2026; https://doi.org/10.1016/j.cpblue.2026.100086
7. Watling CZ, Zhao L, Zhang X, et al. “Artificially Sweetened and Sugar-Sweetened Beverage Intake and Risk of Liver Cancer.” JAMA Netw Open. 2026;9(6):e2617754. doi:10.1001/jamanetworkopen.2026.17754
8. Keck School of Medicine Newsroom. “NIH awards $7.5 million to study whether ‘forever chemicals’ increase the risk of liver and endometrial cancers.” August 26, 2026.
9. Rumgay H, Arnold M, Ferlay J, et al. “Global burden of primary liver cancer in 2020 and predictions to 2040.” J Hepatol. 2022; https://doi.org/10.1016/j.jhep.2022.08.021