For 18 years, the American Cancer Society , the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries have jointly issued the Annual Report to the Nation on the Status of Cancer. This year there is a special emphasis on liver cancer.

Why liver cancer? Because despite the fact that death rates from all cancers are going down in the United States, the incidence of liver cancer and death rates are going up. Men had more than twice the rate of liver cancer than women. The risk increased with age for both men and women.

About 20 percent of liver cancers are caused by hepatitis C. Death rates from hep C-related liver cancers were highest among people born during 1945 through 1965. Hepatitis B also raises the risk for liver cancer. Lifestyle can increase risk of liver cancer; obesity, type 2 diabetes, and drinking too much alcohol can cause cirrhosis, which increases chances of developing liver cancer.

Here are ways to reduce your risk for liver cancer:

Fortunately, new hepatitis C treatments may help to reverse this trend, assuming that people can get tested and treated before hepatitis C has progressed to cirrhosis. However, screening rates are still low, and the majority of those with hep C don’t know that they have it. It’s time we start thinking in terms of hepatitis C tests as liver cancer screening tools. Surely a $20 to $30 test is far cheaper than a colonoscopy, something that doctors do quite routinely.