title: Liver cirrhosis and the risk of primary liver cancer.
abstract: The relationship between liver cirrhosis and hepatocellular carcinoma is recognized, but quantification of risk is still uncertain. Therefore, we analysed data from a case-control study conducted in Italy between 1984 and 1997 on 499 cases of incident, histologically confirmed hepatocellular carcinoma and 1,552 controls in hospital with acute, non-neoplastic disease. Overall, 87 (17.4%) cases vs 10 (0.6%) controls reported clinical history of liver cirrhosis. The corresponding odds ratio (OR) was 27.5 (95% confidence interval (CI), 14.3-15.2) after allowance for sociodemographic factors, and 16.2 (95% CI, 7.9-32.9) after simultaneous allowance for all identified confounding factors, including alcohol consumption and clinical history of hepatitis. The association was of similar magnitude for subjects whose cirrhosis was diagnosed < 55 years (OR = 14.8) or at age 55 or over (OR = 20.0), and the multivariate OR was 33.7 < 5 years after diagnosis of cirrhosis, 37.3 between 5 and 9 years, and 7.6 (95% to 2.7-21.3) > or = 10 years since diagnosis of cirrhosis. The association was stronger in males (OR = 23.4) than in females (OR = 5.9), similar in various age groups, and somewhat stronger in more educated subjects (OR = 53.7), with history of hepatitis (OR = 33.1), reporting heavy alcohol consumption (OR = 24.9) or high body mass index (OR = 58.1), although the interaction term was significant only for sex. In terms of population attributable risk, 17% of hepatocellular carcinomas in this population can be attributed to clinical history of liver cirrhosis.
authors.affiliation: Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.forename: E
authors.initials: E
authors.lastname: Negri
authors.forename: L
authors.initials: L
authors.lastname: Cavalieri d'Oro
authors.forename: S
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000473:pathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012306:Risk