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Hepatocellular and extrahepatic cancer in patients with autoimmune hepatitis - a long-term follow-up study in 634 Swedish patients

Borssen, Asa Danielsson; Almer, Sven; Prytz, Hanne LU ; Wallerstedt, Sven; Friis-Liby, Inga-Lill; Bergquist, Annika; Nyhlin, Nils; Hultcrantz, Rolf; Sangfelt, Per and Weiland, Ola, et al. (2015) In Scandinavian Journal of Gastroenterology 50(2). p.217-223
Abstract
Objectives. Cirrhosis is a well-known risk factor for hepatocellular cancer, but the true risk in autoimmune hepatitis (AIH) is scarcely studied. Other cancers may arise after prolonged use of immune-modulating drugs. The aim of this study was to investigate the cancer risk in a large cohort of AIH patients. Material and methods. Six hundred and thirty-four Swedish patients in a well-defined cohort were matched to the Cause of Death Registry and the Cancer Registry. Standard incidence ratios were calculated by relating the incidences in the cohort to an age-matched material from the Swedish background population. Results. A higher overall incidence of malignancies than the background population was found, counting from the date of... (More)
Objectives. Cirrhosis is a well-known risk factor for hepatocellular cancer, but the true risk in autoimmune hepatitis (AIH) is scarcely studied. Other cancers may arise after prolonged use of immune-modulating drugs. The aim of this study was to investigate the cancer risk in a large cohort of AIH patients. Material and methods. Six hundred and thirty-four Swedish patients in a well-defined cohort were matched to the Cause of Death Registry and the Cancer Registry. Standard incidence ratios were calculated by relating the incidences in the cohort to an age-matched material from the Swedish background population. Results. A higher overall incidence of malignancies than the background population was found, counting from the date of diagnosis (standard incidence ratio (SIR) 2.08, 95% CI 1.68-2.55). The highest risk was found for hepatocellular carcinoma (HCC). We found 10 cases (4.0%) in 248 patients with cirrhosis, which gives an incidence rate of 0.3%. Standard incidence ratio for developing hepatobiliary cancer was 54.55 (95% CI 19.92-99.99). HCC only occurred in cirrhotic patients. There was also an increased risk for non-melanoma skin cancer (SIR 9.87, 95% CI 6.26-14.81). Conclusion. A slightly enhanced risk for malignancies in general compared to the background population was found. The risk of hepatobiliary cancer was increased, but the annual risk over the observational period was well under the postulated 1.5% when surveillance in cirrhotic patients is considered to be cost-effective. (Less)
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organization
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publication status
published
subject
keywords
hepatocellular carcinoma, extrahepatic, cancer, autoimmune hepatitis, autoimmune liver disease
in
Scandinavian Journal of Gastroenterology
volume
50
issue
2
pages
217 - 223
publisher
Taylor & Francis
external identifiers
  • wos:000347692700013
  • scopus:84921377866
ISSN
1502-7708
DOI
10.3109/00365521.2014.983154
language
English
LU publication?
yes
id
7436ba29-fcf2-4aa1-a16f-bc6f5dd85946 (old id 5053365)
date added to LUP
2015-03-02 07:14:10
date last changed
2017-10-22 04:08:08
@article{7436ba29-fcf2-4aa1-a16f-bc6f5dd85946,
  abstract     = {Objectives. Cirrhosis is a well-known risk factor for hepatocellular cancer, but the true risk in autoimmune hepatitis (AIH) is scarcely studied. Other cancers may arise after prolonged use of immune-modulating drugs. The aim of this study was to investigate the cancer risk in a large cohort of AIH patients. Material and methods. Six hundred and thirty-four Swedish patients in a well-defined cohort were matched to the Cause of Death Registry and the Cancer Registry. Standard incidence ratios were calculated by relating the incidences in the cohort to an age-matched material from the Swedish background population. Results. A higher overall incidence of malignancies than the background population was found, counting from the date of diagnosis (standard incidence ratio (SIR) 2.08, 95% CI 1.68-2.55). The highest risk was found for hepatocellular carcinoma (HCC). We found 10 cases (4.0%) in 248 patients with cirrhosis, which gives an incidence rate of 0.3%. Standard incidence ratio for developing hepatobiliary cancer was 54.55 (95% CI 19.92-99.99). HCC only occurred in cirrhotic patients. There was also an increased risk for non-melanoma skin cancer (SIR 9.87, 95% CI 6.26-14.81). Conclusion. A slightly enhanced risk for malignancies in general compared to the background population was found. The risk of hepatobiliary cancer was increased, but the annual risk over the observational period was well under the postulated 1.5% when surveillance in cirrhotic patients is considered to be cost-effective.},
  author       = {Borssen, Asa Danielsson and Almer, Sven and Prytz, Hanne and Wallerstedt, Sven and Friis-Liby, Inga-Lill and Bergquist, Annika and Nyhlin, Nils and Hultcrantz, Rolf and Sangfelt, Per and Weiland, Ola and Lindgren, Stefan and Verbaan, Hans and Werner, Marten},
  issn         = {1502-7708},
  keyword      = {hepatocellular carcinoma,extrahepatic,cancer,autoimmune hepatitis,autoimmune liver disease},
  language     = {eng},
  number       = {2},
  pages        = {217--223},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Hepatocellular and extrahepatic cancer in patients with autoimmune hepatitis - a long-term follow-up study in 634 Swedish patients},
  url          = {http://dx.doi.org/10.3109/00365521.2014.983154},
  volume       = {50},
  year         = {2015},
}