Risk of hepatocellular carcinoma among individuals with different aetiologies of cirrhosis: a population-based cohort study

West, J, Card, TR, Aithal, GP and Fleming, KM ORCID: 0000-0002-6572-5016
(2017) Risk of hepatocellular carcinoma among individuals with different aetiologies of cirrhosis: a population-based cohort study. Alimentary Pharmacology and Therapeutics, 45 (7). pp. 983-990.

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Background Among patients with cirrhosis, only those determined to be at risk for hepatocellular carcinoma (HCC) should undergo surveillance. However, little is known about how different aetiologies of cirrhosis affect risk for HCC. Aim To quantify the cumulative incidence of HCC among a representative population of people with cirrhosis of the liver of varying aetiology. Methods We identified subjects with hepatic cirrhosis from the UK's General Practice Research Database (1987–2006). Diagnoses of HCC were obtained from linked national cancer registries (1971–2006). Cox proportional hazards regression was used to estimate hazard ratios. The predicted 10‐year cumulative incidence of HCC for each aetiology of cirrhosis was estimated while accounting for competing risks of death from any cause and liver transplant. Results Among 3107 people with cirrhosis, the adjusted relative risk of HCC was increased twofold to threefold among people with viral and autoimmune/metabolic aetiologies, compared to those with alcohol‐associated cirrhosis. The 10‐year predicted cumulative incidence estimates of HCC for each aetiology were alcohol, 1.2%; chronic viral hepatitis, 4.0%; autoimmune or metabolic disease, 3.2%; and cryptogenic, 1.1%. Conclusions In a population‐based study in the UK, people with cirrhosis have an estimated cumulative 10‐year incidence of HCC of 4% or lower. Cumulative incidence varies with aetiology such that individuals with alcohol or cryptogenic cirrhosis have the lowest risk for HCC. These findings provide important information for cost‐effectiveness analyses of HCC surveillance.

Item Type: Article
Uncontrolled Keywords: Humans, Carcinoma, Hepatocellular, Liver Neoplasms, Liver Cirrhosis, Liver Transplantation, Incidence, Proportional Hazards Models, Risk, Cohort Studies, Adolescent, Adult, Aged, Middle Aged, Female, Male, Young Adult
Depositing User: Symplectic Admin
Date Deposited: 10 Oct 2017 13:21
Last Modified: 19 Jan 2023 06:53
DOI: 10.1111/apt.13961
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3009905