**2.3.2 Alcohol**

Alcohol consumption has also been linked to primary liver cancer. Mechanisms for direct toxic or carcinogenic effect have not been well-recognized, but it is clear that extended periods of heavy ingestion of more than 60g per day increment the risk for hepatoma. The synergistic effects of alcohol in the presence of hepatitis B or C or both have been established, and seem to have a greater impact in the risk to develop hepatocellular carcinoma (Donato et al., 2002).
