Risk of cancer in patients hospitalized with fatty liver: a Danish cohort study.
OBJECTIVE
To examine the risk of cancer in patients with fatty liver.


BACKGROUND
The relation between liver disease, including fatty liver, and cancer risk is poorly understood.


METHODS
Using the population-based National Registry of Patients, we examined the incidence of cancer in 7,326 patients discharged with a diagnosis of fatty liver from a Danish hospital during 1977-1993. Patients with a prior diagnosis of liver cirrhosis were excluded. We identified cancers through the Danish Cancer Registry. The expected number of cancers was estimated from national age-, sex-, and site-specific incidence rates.


RESULTS
Overall, 523 cancers were diagnosed during 47,594 person-years of follow-up, yielding a 1.7-fold increased risk (95% confidence interval, 1.6-1.9) compared with the Danish general population. The risk of primary liver cancer was markedly elevated in patients with alcoholic as well as nonalcoholic fatty liver with a standardized incidence ratio of 9.5 (95% confidence interval, 5.7-14.8) and 4.4 (95% confidence interval, 1.2-11.4), respectively. Patients with alcoholic fatty liver also had substantially increased risks of several types of cancer associated with alcohol and tobacco use (cancers of the lung, pharynx, larynx, esophagus, and stomach) and a moderately increased risk for cancers of the colon and breast. Among patients with nonalcoholic fatty liver, an increased risk of some alcohol- and tobacco-related cancers was seen, and there was also an increased risk of colon and pancreas cancer.


CONCLUSIONS
Patients discharged with a diagnosis of fatty liver have an increased risk of cancer, in particular liver cancer, most prominently among patients with alcoholic fatty liver.
Sørensen
Henrik Toft
HT
Department of Clinical Epidemiology, Aarhus University Hospital, Denmark. hts@soci.au.dk
Mellemkjaer
Lene
L
Jepsen
Peter
P
Thulstrup
Ane Marie
AM
Baron
John
J
Olsen
Jørgen H
JH
Vilstrup
Hendrik
H
D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005234:Fatty Liver / Q000453:epidemiology* / Q000473:pathology*; D005235:Fatty Liver, Alcoholic / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology*; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution