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Hepatocellular carcinoma risk factors and disease burden in a European cohort: a nested case-control study

Item Type:Article
Title:Hepatocellular carcinoma risk factors and disease burden in a European cohort: a nested case-control study
Creators Name:Trichopoulos, D. and Bamia, C. and Lagiou, P. and Fedirko, V. and Trepo, E. and Jenab, M. and Pischon, T. and Noethlings, U. and Overved, K. and Tjonneland, A. and Outzen, M. and Clavel-Chapelon, F. and Kaaks, R. and Lukanova, A. and Boeing, H. and Aleksandrova, K. and Benetou, V. and Zylis, D. and Palli, D. and Pala, V. and Panico, S. and Tumino, R. and Sacerdote, C. and Bueno-De-Mesquita, H.B. and Van Kranen, H.J. and Peeters, P.H. and Lund, E. and Quiros, J.R. and Gonzalez, C.A. and Sanchez Perez, M.J. and Navarro, C. and Dorronsoro, M. and Barricarte, A. and Lindkvist, B. and Regner, S. and Werner, M. and Hallmans, G. and Khaw, K.T. and Wareham, N. and Key, T. and Romieu, I. and Chuang, S.C. and Murphy, N. and Boffetta, P. and Trichopoulou, A. and Riboli, E.
Abstract:Background: To date, no attempt has been made to systematically determine the apportionment of the hepatocellular carcinoma burden in Europe or North America among established risk factors. Methods: Using data collected from 1992 to 2006, which included 4409809 person-years in the European Prospective Investigation into Cancer and nutrition (EPIC), we identified 125 case patients with hepatocellular carcinoma, of whom 115 were matched to 229 control subjects. We calculated odds ratios (ORs) for the association of documented risk factors for hepatocellular carcinoma with incidence of this disease and estimated their importance in this European cohort. Results: Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection (OR = 9.10, 95% confidence interval [CI] = 2.10 to 39.50 and OR = 13.36, 95% CI = 4.11 to 43.45, respectively), obesity (OR = 2.13, 95% CI = 1.06 to 4.29), former or current smoking (OR = 1.98, 95% CI = 0.90 to 4.39 and OR = 4.55, 95% CI = 1.90 to 10.91, respectively), and heavy alcohol intake (OR = 1.77, 95% CI = 0.73 to 4.27) were associated with hepatocellular carcinoma. Smoking contributed to almost half of all hepatocellular carcinomas (47.6%), whereas 13.2% and 20.9% were attributable to chronic HBV and HCV infection, respectively. Obesity and heavy alcohol intake contributed 16.1% and 10.2%, respectively. Almost two-thirds (65.7%, 95% CI = 50.6% to 79.3%) of hepatocellular carcinomas can be accounted for by exposure to at least one of these documented risk factors. Conclusions: Smoking contributed to more hepatocellular carcinomas in this Europe-wide cohort than chronic HBV and HCV infections. Heavy alcohol consumption and obesity also contributed to sizeable fractions of this disease burden. These contributions may be underestimates because EPIC volunteers are likely to be more health conscious than the general population.
Keywords:Alcohol Drinking, Hepatocellular Carcinoma, Case-Control Studies, Cohort Studies, Cost of Illness, Europe, Follow-Up Studies, Food Habits, Hepatitis B, Hepatitis C, Incidence, Life Style, Liver Neoplasms, Obesity, Odds Ratio, Prevalence, Prospective Studies, Risk Assessment, Risk Factors, Smoking
Source:Journal of the National Cancer Institute
Publisher:Oxford University Press
Page Range:1686-1695
Date:16 November 2011
Additional Information:Authors' reply in: J Natl Cancer Inst 104(21): 1683-1684.
Official Publication:https://doi.org/10.1093/jnci/djr395
PubMed:View item in PubMed

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