The Risk Factors Associated with Liver Cancer at National Hospital in Phnom Penh


Liver cancer
Hepatitis C
Hepatitis B



Cancer is a silent killer without symptom. Many people don’t know that they have it. The GLOBOCAN program from International Agency Research on Cancer 2012 (IARC) showed that liver cancer is a major cancer in less developed countries, with 83% of the estimated 782,000 new cases of cancer worldwide. The main histological types of primary liver cancer globally are hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). The most common causes of liver cancer included hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, tobacco use and alcohol use. However, limited information was documented in Cambodia. This study aimed to describe the characteristics of patients with liver cancer.


This was a cross-sectional study conducted between January and December 2019 in Calmette Hospital based on the patient’s medical records. We reviewed 195 liver cancer patients registered in the Department of Oncology and selected a sample size of 114 liver cancer patients. Descriptive statistical analysis was used to describe the factors related to liver cancer in terms of frequencies and percentages for categorical variables such as sociodemographic characteristics, behavioral risk factors (e.g., use of tobacco, use of alcohol), history of hepatitis B and hepatitis C infections, cirrhosis, diabetes, hypertension, obesity and laboratory results.


There was a higher proportion of men with liver cancer (70.2%) than women (29.8%). Close to 95.0% of liver cancer patients were over 40 years old. Of 114 patients, 63.2% were from provinces, and 36.8% were from Phnom Penh. The main occupations were government (31.6%), household members (28.9%), farmers (21.1%) and petty cash sellers (9.7%). Most (70.2%) liver cancer patients had HCC, followed by CCA (30.8%). Factors associated with liver cancer were HBV and HCV, cirrhosis, and history of smoking cigarettes. There was an association between HBV and HCV and liver cancer type HCC and CCA, with a p-value < 0.001. It was also observed that there was a high proportion of liver cancer among cirrhosis patients. Alpha fetoprotein (AFP) of 5.8 UI/mL was a marker that needed to be considered, especially for HBV and HCV patients. It could indicate about prognosis of cancer development.


The proportion of liver cancer was higher among males than females and aged over 40 years old. The main histological types of primary liver cancer were hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). The factors associated with different types of liver cancer patients were mainly HBV and HCV infections, cirrhosis, and history of smoking. Patients who had HBV with ages over 60 years old and smoking were observed to have liver cancer compared with patients who had HBV without smoking. Patients who have cirrhosis combined with smoking history and hepatitis C disease tended to be associated with the risk of liver cancer disease.