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Viral hepatitis infections pose significantly higher risk for liver cancer than smoking-related lung cancerComparing the risks of liver cancer from hepatitis versus lung cancer from smoking

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Key Takeaway
Recognize that HBV, HCV, and HDV infections carry a higher risk for liver cancer than lung cancer from smoking.

This meta-analysis synthesized data from cohort, case-control, and nested case-control studies involving 86,097,714 participants to compare the risks of liver cancer from various etiologies against the risk of lung cancer from smoking. The study aimed to quantify the relative risk of liver cancer associated with viral hepatitis and other metabolic factors.

The analysis found that HBV, HCV, and HDV infections are associated with significantly higher risks of liver cancer compared to the risk of lung cancer from smoking. Specifically, the odds ratios were 15.2 for HBV (p < 0.001), 12.8 for HCV (p < 0.01), and 23.5 for HDV (p < 0.01). In contrast, MASLD (OR 2.6, p < 0.01) and alcohol use (OR 2.4, p < 0.001) were associated with lower risks of liver cancer compared to the risk of lung cancer from smoking.

The findings highlight viral hepatitis as a significant carcinogenic infectious disease. The authors suggest that these findings support the integration of hepatocellular carcinoma surveillance into the management of patients with viral hepatitis. Limitations regarding the specific study designs and follow-up durations were not reported.

How this fits prior evidence

This meta-analysis addresses a gap in quantifying the relative risk of liver cancer from infectious causes compared to other common carcinogens. It confirms the high risk associated with viral hepatitis, which may be relevant for patients in regions with high HBsAg prevalence, such as the 9.98% to 12.70% reported in Cameroon. It also provides a comparative risk framework for lung cancer, which is relevant to the management of patients receiving TCM nursing or mRNA vaccines for lung cancer.

A large study looked at millions of people to compare different causes of cancer. The researchers looked at how hepatitis viruses and lifestyle choices affect the risk of developing liver cancer. They compared these risks to the risk of developing lung cancer caused by smoking.

People with hepatitis B, C, or D face a very high risk of developing liver cancer. The data shows that these viral infections are much more likely to cause liver cancer than smoking is to cause lung cancer. Specifically, the risk from hepatitis D was the highest among the groups studied.

In contrast, other factors like heavy alcohol use or fatty liver disease (MASLD) were found to have a much lower risk for liver cancer when compared to the risk of lung cancer from smoking. This highlights how dangerous certain viral infections are for liver health.

Doctors can use this information to better manage patients with hepatitis. Because these viruses are so dangerous, patients with hepatitis should receive regular checkups to watch for early signs of liver cancer. This helps doctors catch problems early and provide better care.

What this means for you:
Hepatitis infections pose a significantly higher risk for liver cancer than smoking poses for lung cancer.

Common questions

How does the risk of hepatitis compare to smoking?

The study found that the risk of liver cancer from hepatitis B, C, and D was higher than the risk of lung cancer from smoking. Specifically, the risk for hepatitis B was 15.2 times higher, hepatitis C was 12.8 times higher, and hepatitis D was 23.5 times higher than the reference point of lung cancer risk from smoking.

What other factors were studied regarding liver cancer?

The study also looked at alcohol use and MASLD. These factors were found to have a lower risk of liver cancer compared to the risk of lung cancer from smoking. Alcohol use had an odds ratio of 2.4, and MASLD had an odds ratio of 2.6.

What does this mean for people with hepatitis?

Because viral hepatitis is linked to a high risk of liver cancer, these findings suggest that people with these infections should have regular screenings. You should talk to your doctor about how these findings apply to your specific health needs.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Liver cancer is the second leading cause of premature cancer mortality globally, whose main causes-HBV, HCV, MASH and alcohol use-are preventable. Viral hepatitis' carcinogenicity is not as well-known as the risk of lung cancer from smoking, leading to rising rates of liver cancer worldwide. The aim of this study was to compare the risk of liver cancer in HBV, HCV, HDV, MASH and alcohol consumption with the better-known risk of lung cancer associated with smoking. We extracted the relative risk of liver cancer from HBV, HCV, HDV, MASH, and alcohol use and the relative risk of lung cancer from smoking from previous studies. We included cohort, case-control and nested case-control studies published as original articles. Odds ratios for each factor were pooled globally and by region to test for significant differences. One hundred and twenty-six studies with 86,097,714 participants were included. Relative to the risk of lung cancer and currently smoking (OR 6.0), HBV (OR 15.2, p < 0.001), HCV (OR 12.8, p < 0.01) and HDV (OR 23.5, p < 0.01) were significantly associated with a higher risk of liver cancer, while MASLD (OR 2.6, p < 0.01) and alcohol use (OR 2.4, p < 0.001) were significantly associated with a lower risk of liver cancer. There was no statistically significant difference in liver cancer risk across regions. These findings highlight that viral hepatitis is a carcinogenic infectious disease. Better integration of HCC surveillance within the management of viral hepatitis is critical.
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