Primary liver cancer (hereinafter referred to as liver cancer) is one of the common malignant tumors in China. According to the World Health Organization, there are nearly 750,000 new liver cancer patients and 664,000 deaths worldwide every year, 53.5% of which are Chinese. Among various malignant tumors in China, liver cancer ranks second in the order of death, and liver cancer is the tumor with the worst prognosis among all malignant tumors. With the development of science and technology and the emergence of various new treatment methods and techniques, the treatment of liver cancer has made great progress, but overall, the prognosis is still poor. Currently, the recognized factors for the development of liver cancer include HBV and HCV infections, the ingestion of toxins such as aflatoxin and the consumption of unclean water for many years. In addition, alcohol consumption, smoking, obesity, steatohepatitis and diabetes mellitus may also be related. At present, the national prevention system for liver cancer is mainly a three-level prevention system, and the primary prevention mainly focuses on the prevention of the causes of liver cancer. Secondary prevention is mainly for early detection, early diagnosis and early treatment of liver cancer. Tertiary prevention mainly focuses on the comprehensive treatment of liver cancer. I. Primary prevention of liver cancer: mainly focuses on the prevention of the causes of liver cancer. (a) Prevention of hepatitis: 1. Hepatitis B vaccination. The occurrence of hepatocellular carcinoma is closely related to HBV and HCV. More than 80% of the existing hepatocellular carcinoma patients in China also suffer from chronic hepatitis B or chronic hepatitis C. Chronic viral hepatitis can directly contribute to the carcinogenesis of hepatocytes, which is the basis for the formation of hepatocellular carcinoma. Therefore, effective prevention of viral hepatitis is the most important means to prevent the occurrence of hepatocellular carcinoma. After the implementation of childhood hepatitis program immunization in China, the incidence of hepatitis has decreased significantly. And it has been reported from Taiwan and other regions in China that the incidence of liver cancer has also decreased after the implementation of hepatitis program immunization. In addition to further promotion of planned childhood immunization, it is necessary to consider: (1) practical observation of the effect of immunization, and the need for repeated vaccination if necessary. (2) Families of hepatitis B patients and medical personnel and other high-risk groups should be actively vaccinated against hepatitis B. (3) Parents with chronic hepatitis B infection should consult a physician before having children. For those with high HBV DNA levels, it is best to delay pregnancy and start with antiviral treatment. Immediately after delivery of the fetus, hepatitis B vaccine and hepatitis B immunoglobulin should be administered as prescribed. (4) There is no vaccine to prevent HCV infection. Since HCV infection is mainly transmitted through blood transfusion, it is important to use blood products with caution and strictly sterilize them to prevent medical source infection. 2. For patients with hepatitis B virus, studies have shown that the probability of liver cancer increases in patients with high viral load titers, so antiviral treatment is feasible for some hepatitis B patients. (2) Pay attention to diet and drinking water hygiene. 1. Avoid eating moldy food: At present, aflatoxin B is considered as one of the causes of liver cancer. Peanuts, corn, dried white potatoes, etc. in the home collection are susceptible to aflatoxin contamination, once the above food is found to be moldy, do not eat again. Chlorophyllic acid or chlorophyll-rich foods have the potential to block aflatoxin-induced liver cancer. In addition, rotten fish and meat contain a large amount of amines, and rotten vegetables and fruits contain a large amount of nitrites. Nitrite is very easy to combine with amine to generate carcinogenic nitrosamines. Therefore, we should eat more vegetables, fruits and coarse grains, and less refined rice, refined flour, animal fat and low-fiber food, because coarse grains, vegetables and fruits are rich in minerals and vitamins, which are beneficial to the prevention of liver cancer. 2. Pay attention to drinking water hygiene. Drinking water containing chemical substances can easily induce the occurrence of tumors. Do not drink pond water, it is better to use groundwater as drinking water source. The water tank should be disinfected regularly, and the water tank should use chemicals that will not pollute the water. 3.Appropriate selenium supplementation. For people with low selenium use selenium-rich yeast, selenium polysaccharide, selenium-rich salt to supplement selenium and improve the blood selenium level. (3) Quit smoking, quit drinking, and exercise properly 1. The carcinogens contained in cigarettes have a direct effect on the occurrence of lung cancer and are also related to the production of other tumors such as liver cancer, so it is best to quit smoking. 2.In the past, it was believed that alcohol played a role in the development of liver cancer. However, recent studies have found that alcoholic cirrhosis without hepatitis virus infection also has a certain cancer rate, which means that alcohol is a direct carcinogenic substance. Especially for people with hepatitis B, they should quit drinking. 3, with the improvement of living standards, the number of patients with metabolic syndrome such as high blood fat and diabetes is gradually increasing. Non-alcoholic fatty liver disease is considered to be the manifestation of metabolic syndrome in the liver. Non-alcoholic fatty liver disease causes liver cancer and is even an important cause of liver cancer in Italy. Current studies have shown that diabetes is also an important cause of hepatocellular carcinoma. Therefore, abstaining from alcohol, low-fat diet and increasing physical activity should also be considered as an important part of liver cancer prevention. (4) Don’t take drugs indiscriminately: As the saying goes, “medicine is poisonous in three parts”, most of the drugs are metabolized by liver, so you should not let the drugs damage your liver, so you should ask about the liver toxicity of the drugs in detail before taking them. Chinese and Western medicines that cause more liver damage include: Radix Rehmanniae, Kunming Mountain Begonia, Qian Li Guang, Cang Er Zi, Neem, Neem Bark, Guan Zong, Fang Ji, Huang Yao Zi; Phenytoin Sodium, Furantoin, Ketoconazole, Isoniazid, Rifampin, Pyrazinamide, Paracetamol, Piroxicam, Valproic acid, Carbamazepine, etc. This is also an important means to prevent liver cancer. (E) To have a good state of mind Most of the hepatitis patients have psychopathology and are prone to fear, anxiety, depression and other adverse emotions. It can cause the decrease of body resistance and lead to the growth of tumor. Therefore, while treating physical diseases, we should also care about the psychological state of patients. Family members, relatives and friends should support, care and sympathize with the patients, and the patients themselves should be educated on health knowledge and psychological knowledge to treat the disease correctly. Secondly, secondary prevention of liver cancer is mainly about early detection, early diagnosis and early treatment of liver cancer. For men in the high incidence area of liver cancer, it is recommended to have annual medical checkups, and for high-risk groups with hepatitis or cirrhosis or family history of liver cancer, it is recommended to have medical checkups at least once every six months. The physical examination items are ultrasound examination as well as AFP and liver function test. If there is any doubt in the examination, further detailed examination should be conducted to clarify the diagnosis and provide timely treatment. Thirdly, tertiary prevention of liver cancer refers to active clinical treatment. At present, the treatment methods of primary liver cancer mainly include surgery, transplantation, intervention, minimally invasive, radiotherapy, chemotherapy and biological therapy. According to the patient’s general condition and tumor condition, appropriate comprehensive treatment methods should be chosen. After active and appropriate treatment, there are a large number of patients who survive for more than ten years or even decades after surgery in our hospital. Even if the tumor cannot be removed, the survival period with tumor is significantly extended after comprehensive treatment. One of our patients has complete control of the tumor after two interventions and is currently surviving with tumor for nearly 5 years. Therefore, the prevention of liver cancer is multi-faceted and must start from daily basis, and regular medical checkups should be done to achieve early diagnosis and treatment. There are many treatment methods available, and one should keep an optimistic attitude and have confidence to overcome liver cancer.