Risk of cancer in patients hospitalized with fatty liver: a Danish cohort study -- Hepatitis C Outreach Project

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Subject: Risk of cancer in patients hospitalized with fatty liver: a Danish cohort study

Author:
Sorensen HT,et al; J Clin Gastroenterol. 2003 Apr;36(4):356-9
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Date Posted: Wed, October 08 2003, 16:15:34 PDT
In reply to: Heiner Wedemeyer, MD, Michael P. Manns, MD; Medscape Gastroenterology 5(2), 2003 's message, "Fatty Liver Disease -- It's More Than Alcohol and Obesity" on Wed, October 08 2003, 8:33:22 PDT

J Clin Gastroenterol. 2003 Apr;36(4):356-9.

Risk of cancer in patients hospitalized with fatty liver: a Danish cohort study.

Sorensen HT, Mellemkjaer L, Jepsen P, Thulstrup AM, Baron J, Olsen JH, Vilstrup H.

Department of Clinical Epidemiology, Aarhus University Hospital, Denmark. hts@soci.au.dk

GOALS: To examine the risk of cancer in patients with fatty liver.

BACKGROUND: The relation between liver disease, including fatty liver, and cancer risk is poorly understood.

STUDY: Using the population-based National Registry of Patients, we examined the incidence of cancer in 7,326 patients discharged with a diagnosis of fatty liver from a Danish hospital during 1977-1993. Patients with a prior diagnosis of liver cirrhosis were excluded. We identified cancers through the Danish Cancer Registry. The expected number of cancers was estimated from national age-, sex-, and site-specific incidence rates.

RESULTS: Overall, 523 cancers were diagnosed during 47,594 person-years of follow-up, yielding a 1.7-fold increased risk (95% confidence interval, 1.6-1.9) compared with the Danish general population. The risk of primary liver cancer was markedly elevated in patients with alcoholic as well as nonalcoholic fatty liver with a standardized incidence ratio of 9.5 (95% confidence interval, 5.7-14.8) and 4.4 (95% confidence interval, 1.2-11.4), respectively. Patients with alcoholic fatty liver also had substantially increased risks of several types of cancer associated with alcohol and tobacco use (cancers of the lung, pharynx, larynx, esophagus, and stomach) and a moderately increased risk for cancers of the colon and breast. Among patients with nonalcoholic fatty liver, an increased risk of some alcohol- and tobacco-related cancers was seen, and there was also an increased risk of colon and pancreas cancer.

CONCLUSIONS: Patients discharged with a diagnosis of fatty liver have an increased risk of cancer, in particular liver cancer, most prominently among patients with alcoholic fatty liver.

PMID: 12642745 [PubMed - indexed for MEDLINE]
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>J Clin Gastroenterol. 2003 Apr;36(4):356-9. > > >Risk of cancer in patients hospitalized with fatty >liver: a Danish cohort study. > >Sorensen HT, Mellemkjaer L, Jepsen P, Thulstrup AM, >Baron J, Olsen JH, Vilstrup H. > >Department of Clinical Epidemiology, Aarhus University >Hospital, Denmark. hts@soci.au.dk > >GOALS: To examine the risk of cancer in patients with >fatty liver. > >BACKGROUND: The relation between liver disease, >including fatty liver, and cancer risk is poorly >understood. > >STUDY: Using the population-based National Registry of >Patients, we examined the incidence of cancer in 7,326 >patients discharged with a diagnosis of fatty liver >from a Danish hospital during 1977-1993. Patients with >a prior diagnosis of liver cirrhosis were excluded. We >identified cancers through the Danish Cancer Registry. >The expected number of cancers was estimated from >national age-, sex-, and site-specific incidence >rates. > >RESULTS: Overall, 523 cancers were diagnosed during >47,594 person-years of follow-up, yielding a 1.7-fold >increased risk (95% confidence interval, 1.6-1.9) >compared with the Danish general population. The risk >of primary liver cancer was markedly elevated in >patients with alcoholic as well as nonalcoholic fatty >liver with a standardized incidence ratio of 9.5 (95% >confidence interval, 5.7-14.8) and 4.4 (95% confidence >interval, 1.2-11.4), respectively. Patients with >alcoholic fatty liver also had substantially increased >risks of several types of cancer associated with >alcohol and tobacco use (cancers of the lung, pharynx, >larynx, esophagus, and stomach) and a moderately >increased risk for cancers of the colon and breast. >Among patients with nonalcoholic fatty liver, an >increased risk of some alcohol- and tobacco-related >cancers was seen, and there was also an increased risk >of colon and pancreas cancer. > >CONCLUSIONS: Patients discharged with a diagnosis of >fatty liver have an increased risk of cancer, in >particular liver cancer, most prominently among >patients with alcoholic fatty liver. > >PMID: 12642745 [PubMed - indexed for MEDLINE] >www.hcop.org >hepatitis c outreach project

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