Liver Cancer Risk Isn't Just For Heavy Drinkers Anymore, Doctor Explains Why

For years, liver cancer was considered the disease of heavy drinkers. But now the scenario has changed, and we're diagnosing more cases in people who drink little or not at all. This trend is highlighting the increasing role of lifestyle, diet, and metabolic health in affecting the liver.

Beyond Alcohol: The Rise Of MASLD

The most prevalent form of liver cancer, hepatocellular carcinoma (HCC), has classically arisen in individuals with cirrhosis due to alcohol or chronic viral hepatitis B and C infections. But a new culprit is now appearing in the scene - metabolic dysfunction - associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD).

MASLD is caused by excess fat stored in the liver cells of individuals who drink little to no alcohol. It is closely linked with obesity, type 2 diabetes, and metabolic syndrome. Fatty liver, in time, can evolve into inflammation, fibrosis, cirrhosis, and eventually cancer, even in "healthy" individuals.

In India, rapid urbanization, sedentary lifestyle, and high-calorie diets have made fatty-liver disease a silent epidemic. According to the Indian National Association for the Study of the Liver (INASL), almost one in three urban adults have evidence of fatty-liver changes on ultrasound. Since early fatty-liver stages are symptom-free, most people go undiagnosed until the disease is advanced.

Look For The Warning Signs

Early liver cancer can be silent, but unexplained and chronic fatigue, right-upper-abdominal discomfort, weight loss, or jaundice require immediate investigation. Diabetics, people with metabolic syndrome, or obesity should undergo regular liver-function tests and ultrasounds, even if they are not alcoholics.

Prevention Is The Best Protection

Healthy lifestyles remain the basis for prevention:

• Maintain body weight at a healthy level and consume a balanced diet.
• Limit sugars, refined carbohydrates, and saturated fat.
• Exercise at least 150 minutes per week.
• Manage blood glucose, cholesterol, and blood pressure.
• Be vaccinated against hepatitis B and avoid smoking or drinking excessively.

The myth that "only alcoholics develop liver cancer" is old and harmful. Contemporary liver cancer usually indicates metabolic imbalance, not alcohol use only. Awareness of this changing risk will lead to earlier diagnosis and improved outcomes.

(By Dr Ninad Katdare, Consultant - Surgical Oncology, HCG ICS Khubchandani Cancer Centre, Colaba, Mumbai)

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