Updated October 25, 2026. This article uses the American Cancer Society's 2026 projections and the latest available National Cancer Institute SEER data. Projections for 2026 should not be confused with measured 2026 outcomes.
Liver cancer can develop without obvious early symptoms, particularly in people living with chronic liver disease. Understanding how common the disease is, who faces increased risk, and why stage at diagnosis matters can help people discuss appropriate surveillance with their healthcare team.
How many Americans will be diagnosed with liver cancer in 2026?
The American Cancer Society (ACS) projects 42,340 new cases of liver and intrahepatic bile duct cancer and 30,980 deaths in the United States during 2026. These estimates encompass several primary cancer types, not hepatocellular carcinoma (HCC) alone. [1]
Important: Deaths projected for 2026 are not necessarily among people newly diagnosed in 2026. Dividing annual deaths by new diagnoses does not produce a patient's chance of dying from this cancer.
What is hepatocellular carcinoma (HCC)?
HCC begins in hepatocytes, the principal cells of the liver, and is the most common form of primary liver cancer. In its Cancer Facts & Figures 2026 report, the ACS describes HCC as accounting for approximately 69% of U.S. primary liver cancers and intrahepatic cholangiocarcinoma (bile duct cancer within the liver) for approximately 22%. These are distinct diseases with different clinical features. [2]
HCC is often associated with prolonged liver injury or inflammation, though it can arise without cirrhosis in some patients with hepatitis B. People at risk may feel well despite developing cancer, which is one reason risk-based surveillance is important.
What are the U.S. incidence and death rates?
Observed SEER data provide a different view from ACS annual projections. The National Cancer Institute reports an age-adjusted incidence rate of 9.5 new cases per 100,000 people per year for liver and intrahepatic bile duct cancer during 2019–2023 and an age-adjusted mortality rate of 6.6 deaths per 100,000 per year during 2020–2024. [3]
In ACS 2026 projections, the estimated number of new cases is 27,790 in men versus 14,550 in women. Differences in age-adjusted incidence rates are also evident in SEER: 13.9 per 100,000 men and 5.7 per 100,000 women (2019–2023). These are population rates, not an individual's estimated risk. [3]
What is the five-year survival rate for liver cancer?
For liver and intrahepatic bile duct cancer combined, SEER reports an overall five-year relative survival of 21.9% among people diagnosed during 2016–2022. Relative survival compares survival among people with cancer with the survival expected in a similar general population. It is not a prediction for an individual patient. [3]
Stage at diagnosis makes a substantial difference. SEER reports:
| Extent at diagnosis | 5-year relative survival | Share of diagnoses |
|---|---|---|
| Localized — confined to the primary site | 37.4% | 45% |
| Regional — spread to nearby structures or nodes | 13.4% | 23% |
| Distant — spread to distant sites | 3.6% | 21% |
| Unknown stage | 11.6% | 10% |
Source: NCI SEER Cancer Stat Facts, liver and intrahepatic bile duct cancer. These localized/regional/distant groupings are SEER summary stages; they are not interchangeable with clinical TNM stages I, II, III, or IV. Percentages are rounded. [3]
Earlier-stage detection can increase the range of potentially curative treatments that can be considered, such as liver resection, transplantation, or ablation for appropriately selected patients. However, survival differences across stage groups do not by themselves establish that any specific blood test improves survival.
At what age is liver cancer most commonly diagnosed?
SEER reports a median age at diagnosis of 68 years, with the largest proportion of cases occurring at ages 65–74. Age is one dimension of risk, but younger adults with significant liver disease may also require surveillance. [3]
Is liver cancer becoming more common in the United States?
The longer-term U.S. burden has increased substantially. The ACS reports that liver cancer incidence has roughly tripled over the past four decades. More recent trends are more nuanced: ACS notes stabilization in men and continuing increases among women, while the SEER national overview reports a modest average decline in age-adjusted incidence across the combined liver/intrahepatic bile duct category during 2014–2023. These descriptions differ because they summarize different populations, periods, and statistical methods. [2, 3]
Who is at higher risk of HCC?
Factors associated with HCC include cirrhosis, chronic hepatitis B or hepatitis C, alcohol-related liver disease, and metabolic dysfunction–associated steatotic liver disease (MASLD), particularly when advanced liver fibrosis is present. Diabetes and obesity can contribute to risk through their effects on metabolic liver disease. A family history of HCC and some inherited or other liver diseases also matter in risk assessment. [4]
Population-level U.S. cancer rates also differ across racial and ethnic populations, reflecting the combined effects of disease exposures, access to prevention and care, and other factors. These statistics do not determine an individual's risk. A clinician can assess relevant medical history and whether ongoing surveillance is indicated. [3]
What does current liver cancer surveillance involve?
Unlike colorectal or breast cancer screening, there is no universal liver cancer screening program for all asymptomatic adults. The American Association for the Study of Liver Diseases (AASLD) recommends ultrasound plus alpha-fetoprotein (AFP) approximately every six months for appropriately selected at-risk patients, including many patients with cirrhosis and certain groups with chronic hepatitis B. Surveillance eligibility depends on the patient's clinical circumstances and whether they could benefit from treatment if a cancer is detected. [4]
Ultrasound and AFP have limitations, but a normal AFP result does not exclude HCC, and suspicious findings require appropriate diagnostic evaluation, typically imaging. Blood-based molecular biomarkers are being investigated to provide additional information; they do not replace guideline-recommended imaging surveillance or establish an HCC diagnosis by themselves.
Where does MoleculeDx's research fit?
MoleculeDx's Liver Cancer Fusion Predictor builds on published research examining cell-free cancer-associated fusion-transcript signals in blood and a multi-marker classification approach. This research direction seeks to provide molecular information that differs from traditional protein biomarkers such as AFP. Specific performance figures from research studies should not be interpreted as a guarantee of performance in every patient or population. [5]
Testing decisions and interpretation should be discussed with qualified healthcare professionals. Patients with a negative blood-based test result should continue any recommended surveillance. A positive result requires follow-up; it does not by itself establish a diagnosis of cancer.
Frequently asked questions
How many new liver cancer cases are expected in the United States in 2026?
The ACS projects 42,340 new liver and intrahepatic bile duct cancer diagnoses, including approximately 27,790 in men and 14,550 in women. These estimates include more than HCC alone.
What percentage of patients survive five years after diagnosis?
The NCI SEER estimate is 21.9% overall for the combined cancer-site category, based on patients diagnosed during 2016–2022. Survival is substantially higher for localized disease than for cancers diagnosed after distant spread.
Can HCC be present without symptoms or with normal AFP?
Yes. Early HCC can cause no obvious symptoms, and some HCCs do not raise AFP above the laboratory reference range. A normal AFP value cannot rule out liver cancer.
Who should discuss regular HCC surveillance with a doctor?
People with cirrhosis and certain patients with chronic hepatitis B are among the groups for whom AASLD recommends surveillance. Chronic hepatitis C and other liver conditions also matter, particularly in the setting of cirrhosis. A healthcare professional should assess individual eligibility.
References
- American Cancer Society. Key Statistics About Liver Cancer. Updated January 13, 2026. Read source.
- American Cancer Society. Cancer Facts & Figures 2026, Liver section. Atlanta: ACS; 2026. Read report.
- National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program. Cancer Stat Facts: Liver and Intrahepatic Bile Duct Cancer. Estimates for 2026; observed datasets identified above. View SEER statistics.
- Singal AG, Llovet JM, Yarchoan M, et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology. 2023;78(6):1922–1965. DOI: 10.1097/HEP.0000000000000466.
- Yu YP, Liu S, Geller D, Luo JH. Serum Fusion Transcripts to Assess the Risk of Hepatocellular Carcinoma and the Impact of Cancer Treatment through Machine Learning. American Journal of Pathology. 2024;194:1262–1271. DOI: 10.1016/j.ajpath.2024.02.017.