Among patients with cirrhosis, only those determined to be at risk for hepatocellular carcinoma (HCC) should undergo surveillance.
However, little is known about how different aetiologies of cirrhosis affect risk for HCC.
Dr West and colleagues from the United Kingdom quantified the cumulative incidence of HCC among a representative population of people with cirrhosis of the liver of varying etiology.
The researchers identified subjects with hepatic cirrhosis from the UK's General Practice Research Database.
Diagnoses of HCC were obtained from linked national cancer registries.
Cox proportional hazards regression was used to estimate hazard ratios.
|The 10-year predicted cumulative incidence estimates of HCC was 1% for alcohol|
|Alimentary Pharmacology & Therapeutics|
The research team estimated predicted 10-year cumulative incidence of HCC for each etiology of cirrhosis was, while accounting for competing risks of death from any cause and liver transplant.
Among 3107 people with cirrhosis, the team found that the adjusted relative risk of HCC was increased 2-fold to 3-fold among people with viral and autoimmune/metabolic etiologies, compared to those with alcohol-associated cirrhosis.
The researchers found that the 10-year predicted cumulative incidence estimates of HCC for each etiology were 1% for alcohol, 4% for chronic viral hepatitis, 3% for autoimmune or metabolic disease, and 1% for cryptogenic.
Dr West's team concluded, "In a population-based study in the UK, people with cirrhosis have an estimated cumulative 10-year incidence of HCC of 4% or lower."
"Cumulative incidence varies with etiology such that individuals with alcohol or cryptogenic cirrhosis have the lowest risk for HCC."
"These findings provide important information for cost-effectiveness analyses of HCC surveillance."