Eligibility Details:  
        -  INCLUSION CRITERIA:
        SELECTION OF CASE SUBJECTS (HCC AND HIGH RISK NON-CANCER CASES)
        We will recruit incident cases of pathologically confirmed primary liver cancer or risk
        factors for liver cancer (patients with chronic liver disease due to hepatitis B and/or C
        viral infection, nonalcoholic steatohepatitis or alcoholic cirrhosis) at all stages of the
        disease that are age greater than or equal to 18 years or less than or equal to 90 years.
        Treatment can be surgery or therapy. The following check list will be used to verify
        eligibility of a case subject.
        ELIGIBILITY CRITERIA- HCC CANCER CASES
          1. Diagnosed with primary liver cancer (HCC) within the last two years
          2. Physician diagnosis based on AFP and ultrasound/imaging or Pathological diagnosis of
             primary liver cancer made at the local hospital pathology department
          3. Resides in Maryland or surrounding states
          4. Has a residential working phone within his/her home (*The reason for a participant
             having a residential working phone is that the matching population controls are
             selected through the Department of Motor Vehicles records and must have a residential
             telephone number to be selected as part of the random sample.)
          5. Age is greater than or equal to 18 years and less than or equal to 90 years
          6. A non-objection statement by the physician from the hospital where the patient was
             identified, or listed as the treating physician by the tumor registry or surgical
             pathology report, to contact the patient is obtained
          7. Is not currently residing in an institution, such as a prison, nursing home, or
             shelter
          8. Is not a severely ill patient in the intensive care unit
          9. Is able to give informed consent
         10. Is physically and mentally capable of performing the interview
         11. Must understand English well enough to be interviewed
         12. Has never been interviewed as a control for this study
         13. Subject provides informed consent and signs form.
        ELIGIBITY CRITERIA HIGH RISK NON-CANCER CASES
          1. Has been diagnosed with chronic Hepatitis B or C, NASH or alcoholic liver disease with
             chronicity present at least for a 6 month period
          2. Resides in Maryland or surrounding states
          3. Has a residential working phone within his/her home
          4. Age greater than or equal to 18 years and less than or equal to 90 years
          5. A non-objection statement by the physician from the hospital where the patient was
             identified or is being treated or by the surgical pathology report, to contact the
             patient is obtained
          6. Is not currently residing in an institution, such as a prison, nursing home, or
             shelter
          7. Is not a severely ill patient in the intensive care unit
          8. Is able to give informed consent
          9. Is physically and mentally capable of performing the interview
         10. Must understand English well enough to be interviewed
         11. Has never been interviewed as a control for this study
         12. Subject provides informed consent and signs form.
        SELECTION OF POPULATION-BASED CONTROLS
        Population-based controls will be identified through the Motor Vehicle Administration
        (MVA), and matched on age (year of birth), race, gender and geography to cases. We sample
        controls in proportion to the population size of their county of residence. Recruitment of
        controls will start concurrently with case accrual, using the age, race and gender
        frequency distribution of cancer patients in previous years. The sampling frame is
        continually updated as we accrue information on the case distribution of age, race and
        gender. We will exclude controls that do not have a listed home phone number. The following
        check list will be used to verify eligibility of a control subject.
        ELIGIBILITY CRITERIA - POPULATION-BASED CONTROLS
          1. Resides in Baltimore City, Anne Arundel, Baltimore, Caroline, Carroll, Cecil,
             Dorchester, Harford, Howard, Kent, Queen Anne s, Somerset, Talbot, Wicomica and
             Worchester County.
          2. Has a residential working phone within his/her home
          3. Age greater than or equal to 18 years and less than or equal 90 years
          4. Have never had radiation therapy or chemotherapy
          5. Is not currently residing in an institution, such as a prison, nursing home, or
             shelter
          6. Is physically and mentally capable of performing the interview
          7. Must understand English well enough to be interviewed
          8. Has never been interviewed as a control for the study
          9. Subject provides informed consent and signs form.
        EXCLUSION CRITERIA:
        Exclusion Criteria-HCC CANCER CASES
          1. Liver cancer patients who are older than 90 years are excluded because of co-morbidity
             considerations and the difficulty of matching those cases with population-based
             controls.
          2. Children and institutionalized patients are excluded from the proposed study. Very few
             HCC patients at the 3 participating hospitals are younger than 18 years of age and HCC
             incidence mainly occurs in adults.
        Exclusion Criteria-HCC HIGH-RISK NON-CANCER CASES
          1. High Risk Non-Cancer patients who are older than 90 years are excluded because of
             co-morbidity considerations and the difficulty of matching those cases with
             population-based controls.
          2. Children and institutionalized patients are excluded from the proposed study. Very few
             HCC patients at the 3 participating hospitals are younger than 18 years of age and HCC
             incidence mainly occurs in adults. High-Risk Non-Cancer cases who are younger than 18
             years are excluded due to the need of matching with HCC cases and population controls.
        Exclusion Criteria-POPULATION BASED CONTROLS
          1. Population based controls who are older than 90 years are excluded because of
             co-morbidity considerations and the difficulty of matching with HCC cases and high
             risk non-cancer cases.
          2. Population controls who are younger than 18 years or are institutionalized are
             excluded due to the need of matching with HCC cases and high-risk non-cancer cases.
          3. Population controls with prior cancer with the exception of non-melanomic skin cancer
             (squamous or basal cell).