What makes some people with hepatitis c more or less likely to get liver cancer?

Cirrhosis: Patients with hepatitis C and liver cirrhosis are at the highest risk of liver cancer (hcc). Patients with hepatitis C but no cirrhosis are at an extremely low risk for hcc and don't require screening.

Cirrhosis: In hepatitis c, you must have cirrhosis, prior to developing liver cancer. Alcohol, obesity, diabetes and HIV meds can accelerate liver damage leading to cirrhosis at a faster rate.