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Personal comorbidities and their subsequent risks for liver, gallbladder and bile duct cancers

Hemminki, Kari LU ; Sundquist, Kristina LU ; Sundquist, Jan LU ; Försti, Asta LU ; Liska, Vaclav ; Hemminki, Akseli and Li, Xinjun LU (2023) In International Journal of Cancer 152(6). p.1107-1114
Abstract

Many environmental risk factors for hepatobiliary cancers are known but whether they are associated with specific cancer types is unclear. We present here a novel approach of assessing standardized incidence ratios (SIRs) of previously diagnosed comorbidities for hepatocellular carcinoma (HCC), gallbladder cancer (GBC), cholangiocarcinoma (CCA) and ampullary cancer. The 13 comorbidities included alcohol and nonalcohol related liver disease, chronic obstructive pulmonary disease, gallstone disease, viral and other kinds of hepatitis, infection of bile ducts, hepatic and other autoimmune diseases, obesity and diabetes. Patients were identified from the Swedish Inpatient Register from 1987 to 2018, and their cancers were followed from 1997... (More)

Many environmental risk factors for hepatobiliary cancers are known but whether they are associated with specific cancer types is unclear. We present here a novel approach of assessing standardized incidence ratios (SIRs) of previously diagnosed comorbidities for hepatocellular carcinoma (HCC), gallbladder cancer (GBC), cholangiocarcinoma (CCA) and ampullary cancer. The 13 comorbidities included alcohol and nonalcohol related liver disease, chronic obstructive pulmonary disease, gallstone disease, viral and other kinds of hepatitis, infection of bile ducts, hepatic and other autoimmune diseases, obesity and diabetes. Patients were identified from the Swedish Inpatient Register from 1987 to 2018, and their cancers were followed from 1997 onwards. SIRs for HCC were 80 to 100 in men and women diagnosed with hepatitis C virus and they were also >10 in patients diagnosed with hepatitis B virus, other kind of hepatitis, hepatic autoimmune disease and nonalcohol related liver disease. Many of these risks, as well as alcohol related liver disease, were either specific to HCC or were shared with intrahepatic CCA. For GBC, CCA and ampullary cancer infection of bile ducts was the main risk factor. Gallstone disease, nonhepatic autoimmune diseases and diabetes were associated with all hepatobiliary cancers. The limitations of the study include inability to cover some rare risk factors and limited follow-up time. Many of the considered comorbidities are characterized by chronic inflammation and/or overt immune disturbance in autoimmune diseases. The results suggest that local chronic inflammation and a related immune disturbance is the carcinogenic trigger for all these cancers.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
alcohol, comorbidity, familial risk, hepatocellular carcinoma, risk factor, smoking
in
International Journal of Cancer
volume
152
issue
6
pages
1107 - 1114
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:36196489
  • scopus:85139469667
ISSN
0020-7136
DOI
10.1002/ijc.34308
language
English
LU publication?
yes
id
2384f17d-ce6d-44b8-afa9-3d9ede2611b7
date added to LUP
2022-12-14 10:47:14
date last changed
2024-08-04 21:03:44
@article{2384f17d-ce6d-44b8-afa9-3d9ede2611b7,
  abstract     = {{<p>Many environmental risk factors for hepatobiliary cancers are known but whether they are associated with specific cancer types is unclear. We present here a novel approach of assessing standardized incidence ratios (SIRs) of previously diagnosed comorbidities for hepatocellular carcinoma (HCC), gallbladder cancer (GBC), cholangiocarcinoma (CCA) and ampullary cancer. The 13 comorbidities included alcohol and nonalcohol related liver disease, chronic obstructive pulmonary disease, gallstone disease, viral and other kinds of hepatitis, infection of bile ducts, hepatic and other autoimmune diseases, obesity and diabetes. Patients were identified from the Swedish Inpatient Register from 1987 to 2018, and their cancers were followed from 1997 onwards. SIRs for HCC were 80 to 100 in men and women diagnosed with hepatitis C virus and they were also &gt;10 in patients diagnosed with hepatitis B virus, other kind of hepatitis, hepatic autoimmune disease and nonalcohol related liver disease. Many of these risks, as well as alcohol related liver disease, were either specific to HCC or were shared with intrahepatic CCA. For GBC, CCA and ampullary cancer infection of bile ducts was the main risk factor. Gallstone disease, nonhepatic autoimmune diseases and diabetes were associated with all hepatobiliary cancers. The limitations of the study include inability to cover some rare risk factors and limited follow-up time. Many of the considered comorbidities are characterized by chronic inflammation and/or overt immune disturbance in autoimmune diseases. The results suggest that local chronic inflammation and a related immune disturbance is the carcinogenic trigger for all these cancers.</p>}},
  author       = {{Hemminki, Kari and Sundquist, Kristina and Sundquist, Jan and Försti, Asta and Liska, Vaclav and Hemminki, Akseli and Li, Xinjun}},
  issn         = {{0020-7136}},
  keywords     = {{alcohol; comorbidity; familial risk; hepatocellular carcinoma; risk factor; smoking}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1107--1114}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Personal comorbidities and their subsequent risks for liver, gallbladder and bile duct cancers}},
  url          = {{http://dx.doi.org/10.1002/ijc.34308}},
  doi          = {{10.1002/ijc.34308}},
  volume       = {{152}},
  year         = {{2023}},
}