Because<unk>  mostly occurs in people with cirrhosis of the liver, risk factors generally include factors which cause chronic liver disease that may lead to cirrhosis. Still, certain risk factors are much more highly associated with<unk>  than others. For example, while heavy alcohol consumption is estimated to cause 60–70% of cirrhosis, the vast majority of<unk>  occurs in cirrhosis attributed to viral hepatitis (although there may be overlap). Recognized risk factors include: * Chronic viral hepatitis (estimated cause of 80% cases globally) * Chronic hepatitis B (about 50% cases) * Chronic hepatitis C (about 25% cases) * Toxins: * Alcohol use disorder: the most common cause of cirrhosis * Aflatoxin * Iron overload state (hemochromatosis) * Pyrrolizidine alkaloids * Metabolic: * Nonalcoholic steatohepatitis: up to 20% progress to cirrhosis * Nonalcoholic fatty liver disease * Type 2 diabetes (probably aided by obesity) * Congenital disorders: * Alpha 1-antitrypsin deficiency * Wilson's disease (controversial; while some theorise the risk increases, case studies are rare and suggest the opposite where Wilson's disease actually may confer protection) * Hemophilia, although statistically associated with higher risk of<unk> , this is due to coincident chronic viral hepatitis infection related to repeated blood transfusions over lifetime. The significance of these risk factors varies globally. In regions where hepatitis B infection is endemic, such as southeast China, this is the predominant cause. In populations largely protected by hepatitis B vaccination, such as the United States,<unk>  is most often linked to causes of cirrhosis such as chronic hepatitis C, obesity, and excessive alcohol use. Certain benign liver tumors, such as<unk>  adenoma, may sometimes be associated with coexisting malignant<unk> . Evidence is limited for the true incidence of malignancy associated with benign adenomas; however, the size of hepatic adenoma is considered to correspond to risk of malignancy and so larger tumors may be surgically removed. Certain subtypes of adenoma, particularly those with β-catenin activation mutation, are particularly associated with increased risk of<unk> . Chronic liver disease is rare in children and adolescents; however, congenital liver disorders are associated with an increased the chance of developing<unk> . Specifically, children with biliary atresia, infantile cholestasis, glycogen-storage diseases, and other cirrhotic diseases of the liver are predisposed to developing<unk>  in childhood. Young adults afflicted by the rare fibrolamellar variant of<unk>  may have none of the typical risk factors, i.e. cirrhosis and hepatitis. Diabetes mellitus The risk of<unk>  in type 2 diabetics is greater (from 2.5 to 7.1 times the nondiabetic risk) depending on the duration of diabetes and treatment protocol. A suspected contributor to this increased risk is circulating insulin concentration such that diabetics with poor insulin control or on treatments that elevate their insulin output (both states that contribute to a higher circulating insulin concentration) show far greater risk of<unk>  than diabetics on treatments that reduce circulating insulin concentration. On this note, some diabetics who engage in tight insulin control (by keeping it from being elevated) show risk levels low enough to be indistinguishable from the general population. This phenomenon is thus not isolated to diabetes mellitus type 2, since poor insulin regulation is also found in other conditions such as metabolic syndrome (specifically, when evidence of nonalcoholic fatty liver disease or NAFLD is present) and again evidence of greater risk exists here, too. While there are claims that anabolic steroid abusers are at greater risk (theorized to be due to insulin and IGF exacerbation), the only evidence that has been confirmed is that anabolic steroid users are more likely to have the benign<unk>  adenomas transform into the more dangerous<unk> .
Hepatocellular carcinoma
Hepatoid tumor
Focal fatty liver
Cholangiocarcinoma
Hepatoblastoma
Echinococcosis
Liver angiosarcoma
Metastatic carcinoma