Associations between autoimmune conditions and hepatobiliary cancer risk among elderly US adults
(2019) In International Journal of Cancer 144(4). p.707-717- Abstract
Growing evidence suggests that people with autoimmune conditions may be at increased risk of hepatobiliary tumors. In the present study, we evaluated associations between autoimmune conditions and hepatobiliary cancers among adults aged ≥66 in the United States. We used Surveillance, Epidemiology, and End Results (SEER)-Medicare data (1992–2013) to conduct a population-based, case–control study. Cases (n = 32,443) had primary hepatobiliary cancer. Controls (n = 200,000) were randomly selected, cancer-free adults frequency-matched to cases by sex, age and year of selection. Using multivariable logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) for associations with 39 autoimmune conditions identified... (More)
Growing evidence suggests that people with autoimmune conditions may be at increased risk of hepatobiliary tumors. In the present study, we evaluated associations between autoimmune conditions and hepatobiliary cancers among adults aged ≥66 in the United States. We used Surveillance, Epidemiology, and End Results (SEER)-Medicare data (1992–2013) to conduct a population-based, case–control study. Cases (n = 32,443) had primary hepatobiliary cancer. Controls (n = 200,000) were randomly selected, cancer-free adults frequency-matched to cases by sex, age and year of selection. Using multivariable logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) for associations with 39 autoimmune conditions identified via Medicare claims. We also conducted separate analyses for diagnoses obtained via inpatient versus outpatient claims. Sixteen conditions were associated with at least one hepatobiliary cancer. The strongest risk estimates were for primary biliary cholangitis with hepatocellular carcinoma (OR: 31.33 [95% CI: 23.63–41.56]) and primary sclerosing cholangitis with intrahepatic cholangiocarcinoma (7.53 [5.73–10.57]), extrahepatic cholangiocarcinoma (5.59 [4.03–7.75]), gallbladder cancer (2.06 [1.27–3.33]) and ampulla of Vater cancer (6.29 [4.29–9.22]). Associations with hepatobiliary-related conditions as a group were observed across nearly all cancer sites (ORs ranging from 4.53 [95% CI: 3.30–6.21] for extrahepatic cholangiocarcinoma to 7.18 [5.94–8.67] for hepatocellular carcinoma). Restricting to autoimmune conditions diagnosed via inpatient claims, 6 conditions remained associated with at least one hepatobiliary cancer, and several risk estimates increased. In the outpatient restricted analysis, 12 conditions remained associated. Multiple autoimmune conditions are associated with hepatobiliary cancer risk in the US Medicare population, supporting a shared immuno-inflammatory etiology to these cancers.
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- author
- McGee, Emma E. ; Castro, Felipe A. ; Engels, Eric A. ; Freedman, Neal D. ; Pfeiffer, Ruth M. ; Nogueira, Leticia ; Stolzenberg-Solomon, Rachael ; McGlynn, Katherine A. ; Hemminki, Kari LU and Koshiol, Jill
- organization
- publishing date
- 2019-02-15
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- ampulla of Vater cancer, extrahepatic cholangiocarcinoma, gallbladder cancer, hepatocellular carcinoma, intrahepatic cholangiocarcinoma
- in
- International Journal of Cancer
- volume
- 144
- issue
- 4
- pages
- 707 - 717
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- pmid:30155920
- scopus:85056319619
- ISSN
- 0020-7136
- DOI
- 10.1002/ijc.31835
- language
- English
- LU publication?
- yes
- id
- 8008fa4f-b1b2-4dfe-bb15-4b8a33102df3
- date added to LUP
- 2018-11-23 10:51:18
- date last changed
- 2024-04-15 16:42:56
@article{8008fa4f-b1b2-4dfe-bb15-4b8a33102df3,
abstract = {{<p>Growing evidence suggests that people with autoimmune conditions may be at increased risk of hepatobiliary tumors. In the present study, we evaluated associations between autoimmune conditions and hepatobiliary cancers among adults aged ≥66 in the United States. We used Surveillance, Epidemiology, and End Results (SEER)-Medicare data (1992–2013) to conduct a population-based, case–control study. Cases (n = 32,443) had primary hepatobiliary cancer. Controls (n = 200,000) were randomly selected, cancer-free adults frequency-matched to cases by sex, age and year of selection. Using multivariable logistic regression, we calculated odds ratios (ORs) and 95% confidence intervals (CIs) for associations with 39 autoimmune conditions identified via Medicare claims. We also conducted separate analyses for diagnoses obtained via inpatient versus outpatient claims. Sixteen conditions were associated with at least one hepatobiliary cancer. The strongest risk estimates were for primary biliary cholangitis with hepatocellular carcinoma (OR: 31.33 [95% CI: 23.63–41.56]) and primary sclerosing cholangitis with intrahepatic cholangiocarcinoma (7.53 [5.73–10.57]), extrahepatic cholangiocarcinoma (5.59 [4.03–7.75]), gallbladder cancer (2.06 [1.27–3.33]) and ampulla of Vater cancer (6.29 [4.29–9.22]). Associations with hepatobiliary-related conditions as a group were observed across nearly all cancer sites (ORs ranging from 4.53 [95% CI: 3.30–6.21] for extrahepatic cholangiocarcinoma to 7.18 [5.94–8.67] for hepatocellular carcinoma). Restricting to autoimmune conditions diagnosed via inpatient claims, 6 conditions remained associated with at least one hepatobiliary cancer, and several risk estimates increased. In the outpatient restricted analysis, 12 conditions remained associated. Multiple autoimmune conditions are associated with hepatobiliary cancer risk in the US Medicare population, supporting a shared immuno-inflammatory etiology to these cancers.</p>}},
author = {{McGee, Emma E. and Castro, Felipe A. and Engels, Eric A. and Freedman, Neal D. and Pfeiffer, Ruth M. and Nogueira, Leticia and Stolzenberg-Solomon, Rachael and McGlynn, Katherine A. and Hemminki, Kari and Koshiol, Jill}},
issn = {{0020-7136}},
keywords = {{ampulla of Vater cancer; extrahepatic cholangiocarcinoma; gallbladder cancer; hepatocellular carcinoma; intrahepatic cholangiocarcinoma}},
language = {{eng}},
month = {{02}},
number = {{4}},
pages = {{707--717}},
publisher = {{John Wiley & Sons Inc.}},
series = {{International Journal of Cancer}},
title = {{Associations between autoimmune conditions and hepatobiliary cancer risk among elderly US adults}},
url = {{http://dx.doi.org/10.1002/ijc.31835}},
doi = {{10.1002/ijc.31835}},
volume = {{144}},
year = {{2019}},
}