Preventable liver cancer cases through reduced exposure to overweight/obesity, alcohol consumption, tobacco use, and hepatitis B infection

Introduction: Liver cancer is among the most prevalent cancers globally and in Colombia. Key modifiable risk factors include overweight/obesity, excessive alcohol consumption, tobacco use, and hepatitis B virus (HBV) infection. This study aimed to estimate the potential impact of reducing exposure to these modifiable risk factors on liver cancer incidence in Colombia from 2016 to 2050. Methods: A population-based microsimulation model was implemented using the Prevent V3.1 software. The model integrates age- and sex-specific liver cancer incidence rates, latency and lag times, risk factor prevalence (with and without interventions), relative risks, and national demographic projections. Results: A 10% reduction in the prevalence of risk factors could prevent up to 728 liver cancer cases. Complete elimination of exposure could avert up to 8,648 new cases during the study period. The population attributable fractions (PAF) were 1.09% for HBV infection, 1.90% for alcohol consumption, 6.14% for tobacco use, and 14.52% for overweight/obesity. Conclusions: Reducing population-level exposure to overweight/obesity, alcohol consumption, tobacco, and HBV infection could substantially decrease the future burden of liver cancer incidence in Colombia. These projections support prioritizing risk factor reduction in national cancer prevention and public health strategies.