Alcohol has been shown to be an important risk factor for hepatocellular carcinoma (HCC).
The role of tobacco as a risk factor for hepatocellular carcinoma is controversial.
Recently, obesity has been reported to be a risk factor for hepatocellular carcinoma.
Dr Marrero and colleagues from Michigan, America investigated whether these factors increase the risk of hepatocellular carcinoma in American patients.
The research team enrolled consecutive patients with hepatocellular carcinoma, cirrhosis without hepatocellular carcinoma and, control patients without liver disease in order to assess their exposure to risk factors.
|Risk of HCC increased 6-fold for alcohol and 5-fold for tobacco
|Journal of Hepatology|
When the researchers compared HCC cases to cirrhotic controls, they found that the risk of HCC increased 6-fold for alcohol, 5-fold for tobacco and 4-fold with obesity.
The research team used spline regression, in order to reveal a dose-dependent relationship between alcohol and tobacco exposure with risk of HCC.
There was significant interaction between alcohol, tobacco and obesity, with synergistic indices greater than 1.
Dr Marrero concluded, "Alcohol, tobacco and obesity are independent risk factors for HCC in our patient population, and they interact synergistically to increase the risk of HCC."
"Data from this study may allow us to stratify cirrhotics into low- and high-risk groups for the development of HCC surveillance strategies."