According to Mindie H. Nguyen and colleagues, writing in the September edition of the journal Clinical Gastroenterology & Hepatology, hepatocellular carcinoma (HCC) is more common in the United States among Asians and African Americans than Caucasians, with up to half of these patients suffering from chronic hepatitis C virus (HCV) infection.
Dr Nguyen and colleagues therefore decided to examine ethnicity as a potential risk factor for HCC among patients with chronic hepatitis C.
To do this, the scientists conducted a case-controlled study of 464 patients with chronic hepatitis C and cirrhosis (207 cancer patients and 257 controls) using medical records and pathology reports, at 4 medical centers.
| Liver cancer risk in chronic hepatitis C and cirrhosis patients: increased 4-fold in Asians and up to 2-fold in African-American men compared with Caucasians|
|Clinical Gastroenterology & Hepatology|
Odds-ratios with 95% confidence intervals were estimated by using conditional logistic regression on case-control sets, matched within study centers and study period on sex and age groups.
To control for potential confounding caused by severity of cirrhosis and residual confounding caused by age, the researchers also included Child-Turcotte-Pugh (CTP) scores and age (continuous variable) in all regression analyses.
The researchers found that, compared with Caucasians, the cancer risk was increased significantly among Asians (adjusted odds ratio, 4.3; 95% confidence interval, 2.1–9.0 for men, and 4.6; 1.2–18.5 for women) and somewhat increased among African-American men (adjusted odds ratio, 2.4; 95% confidence interval, 0.9–6.3).
These findings suggest, conclude the researchers, that among patients with chronic hepatitis C and cirrhosis, liver cancer risk is increased 4-fold in Asians and may be doubled in African-American men, compared with Caucasians.
They caution however, that the results need confirmation in larger studies from racially diverse populations but add that, if confirmed, these results point to high-risk populations that should be targeted for screening and preventive efforts.