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Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: A prospective cohort study in Korea.

Authors
 Sang‐Wook Yi  ;  Ja‐Sung Choi  ;  Jee‐Jeon Yi  ;  Yong‐ho Lee  ;  Ki Jun Han 
Citation
 Cancer, Vol.124(13) : 2748-2757, 2018 
Journal Title
 Cancer 
ISSN
 0008-543X 
Issue Date
2018
Keywords
alcohol consumption ; cirrhosis ; hepatocellular carcinoma (HCC) ; liver cancer ; viral hepatitis
Abstract
BACKGROUND: To the authors' knowledge, relatively little is known regarding the interaction of risk factors for hepatocellular carcinoma (HCC) with age, sex, and liver disorder status. METHODS: The authors followed 504,646 Korean patients aged 40 to 80 years who underwent routine health checkups between 2002 and 2003 until 2013 via linkage to national hospital discharge records. RESULTS: HCC occurred in 2744 individuals. In the sex-adjusted and age-adjusted analysis, cirrhosis increased the incidence of HCC by 42-fold, followed by hepatitis B virus (21-fold), hepatitis C virus (HCV; 19-fold), male sex (4.3-fold), and each 5-year age increment (1.24-fold). In the multivariable adjusted analysis, diabetes increased the risk of HCC by 80%, alcohol consumption ≥80 g/day increased the risk by 75%, alcohol consumption of 40 to 79 g/day increased the risk by 37%, and being a current smoker increased the risk by 25%. The multivariable adjusted hazard ratios of male sex and HCV were 6.27 and 5.72, respectively, at age <50 years, but were 2.09 and 22.51, respectively, at age ≥70 years. Each 20 g/day of alcohol consumption increased the risk of HCC by 6% (P = .11), 8% (P = .02), 16% (P<.001), and 30% (P<.001), respectively, in individuals aged <50 years, 50 to 59 years, 60 to 69 years, and 70 to 80 years. In individuals without a liver disorder, body mass index was found to be positively associated with HCC, whereas patients with a liver disorder demonstrated an inverse association. Women had higher adjusted hazard ratios associated with age and cirrhosis compared with men. CONCLUSIONS: With advancing age, the effects of alcohol use and HCV on the development of HCC become stronger, whereas the effect of male sex weakens. Lifetime moderate alcohol consumption may cause HCC in the elderly. Smoking increases the risk of HCC irrespective of viral hepatitis, and diabetes increases the risk of HCC independent of cirrhosis. Cancer 2018;124:2748-2757. © 2018 American Cancer Society.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1002/cncr.31406
DOI
10.1002/cncr.31406
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
이용호(Lee, Yong Ho) ORCID logo https://orcid.org/0000-0002-6219-4942
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163693
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