The team prospectively analyzed the risk of primary liver and extrahepatic biliary tract cancer in patients hospitalized with chronic viral hepatitis, alcoholism, or cirrhosis.
They reported their findings in the October issue of Hepatology.
A total of 186,395 such patients, hospitalized in Sweden, were included in the study.
|186,395 patients were prospectively analyzed.
Compared with the general population, the relative risk of hepatocellular carcinoma was 40.7 for cirrhosis alone, 34.4 for chronic viral hepatitis alone, and 2.4 for alcoholism alone.
The relative risk of hepatocellular carcinoma among patients with combinations of these risk conditions was also evaluated. These were 27.3 for chronic viral hepatitis and alcoholism, 118.5 for chronic viral hepatitis and cirrhosis, 22.4 for alcoholism and cirrhosis, and 171.4 for all 3 conditions.
The researchers found limited evidence for an excess risk of intrahepatic, but not for extrahepatic, biliary duct cancer.
Investigator Hannah Kuper, of the Department of Epidemiology and Public Health, University College London, concluded on behalf of her colleagues, "Cirrhosis amplifies the risk of hepatocellular carcinoma among patients with chronic viral hepatitis, but it is not a prerequisite for liver carcinogenesis.
"In contrast, cirrhosis may be a necessary intermediate for the development of hepatocellular carcinoma among alcoholics."