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Review
. 2025 Jan 16;9(2):e0627.
doi: 10.1097/HC9.0000000000000627. eCollection 2025 Feb 1.

Environmental exposures and the risk of hepatocellular carcinoma

Divya Rayapati  1 , Katherine A McGlynn  2 , John D Groopman  3 , Amy K Kim  1
Affiliations
Review

Environmental exposures and the risk of hepatocellular carcinoma

Divya Rayapati et al. Hepatol Commun. .

Abstract

The global epidemiology of HCC is shifting due to changes in both established and emerging risk factors. This transformation is marked by an emerging prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes, alongside traditional risks such as viral hepatitis (HBV and HCV), and exposure to chemical agents like aflatoxin, alcohol, tobacco, and air pollution. This review examines how environmental exposures and evolving liver pathology, exacerbated by lifestyle and metabolic conditions, are contributing to the rising worldwide incidence of HCC. Effective prevention strategies must not only address traditional risk factors through vaccination and therapeutic measures but also confront metabolic and socioeconomic disparities through comprehensive public health efforts. As the burden of liver cancer continues to grow, particularly in resource-limited settings, an expansive and inclusive approach is vital for mitigating its impact across diverse populations.

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Conflict of interest statement

The authors have no conflicts to report.

Figures

FIGURE 1
FIGURE 1
Integrated model of major risk factors for liver cancer. Abbreviations: AFB1, aflatoxin; MASLD, metabolic dysfunction–associated steatotic liver disease; MASH, metabolic dysfunction–associated steatohepatitis; T2DM, type 2 diabetes mellitus.
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