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Associations between autoimmune conditions and hepatobiliary cancer risk among elderly US adults

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 (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
organization
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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
external identifiers
  • 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
2019-02-15 04:30:00
@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},
  keyword      = {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},
  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},
  volume       = {144},
  year         = {2019},
}