title: Hepatic and extrahepatic malignancies in autoimmune hepatitis. A long-term follow-up in 473 Swedish patients.
abstract: OBJECTIVE
  Autoimmune Hepatitis (AIH) is a liver disease which may lead to liver cirrhosis. Cirrhosis is a well-known risk factor for hepatocellular cancer. Lymphoma is a disease, where immune modulating drugs as well as the autoimmune disease itself may contribute to the elevated risk. The aim was to investigate the risks of malignancies in a large cohort of AIH patients.
  
  
  METHODS
  Four hundred and seventy-three patients with AIH were matched to the Swedish national cancer register as well as to the death cause register.
  
  
  RESULTS
  We found an overall higher risk of malignancies in the cohort of AIH patients from the date of diagnosis with a SIR of 1.51 (95% CI 1.10-2.03). SIR in the subpopulation of well defined catchment areas and complete case finding was 23.28 (95% CI 7.5-54.34) for HCC. Lymphomas were found a SIR of 13.09 (95% CI 4.22-30.56).
  
  
  CONCLUSIONS
  There was an overall increased risk of malignancies in a cohort of AIH patients, which manly was caused by hepatobiliary cancers. However, the true risk of HCC in an AIH cirrhotic cohort has yet to be investigated. A significantly higher risk of lymphomas was also found, but no clear cut association to the use of immune modulators.
authors.affiliation: Department of Medicine Sections for Hepatology and Gastroenterology, Umeå University Hospital, SE-90185 Umeå, Sweden. marten.werner@vll.se
authors.forename: Mårten
authors.initials: M
authors.lastname: Werner
authors.forename: Sven
authors.initials: S
authors.lastname: Almer
authors.forename: Hanne
authors.initials: H
authors.lastname: Prytz
authors.forename: Stefan
authors.initials: S
authors.lastname: Lindgren
authors.forename: Sven
authors.initials: S
authors.lastname: Wallerstedt
authors.forename: Einar
authors.initials: E
authors.lastname: Björnsson
authors.forename: Annika
authors.initials: A
authors.lastname: Bergquist
authors.forename: Hanna
authors.initials: H
authors.lastname: Sandberg-Gertzén
authors.forename: Rolf
authors.initials: R
authors.lastname: Hultcrantz
authors.forename: Per
authors.initials: P
authors.lastname: Sangfelt
authors.forename: Ola
authors.initials: O
authors.lastname: Weiland
authors.forename: Ake
authors.initials: A
authors.lastname: Danielsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003110:Colonic Neoplasms / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D019693:Hepatitis, Autoimmune / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology*; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000209:etiology