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Risks of Hepatocellular Carcinoma Elaborated in European Studies
While a causal link between hepatitis B and C and hepatocellular cancer has been known for a few decades, tobacco smoking, obesity, and alcohol consumption are common risk factors, albeit with lower relative risks, that also contribute to the development of the disease. In fact, there were many more Europeans with hepatocellular cancer who were smokers than carriers of hepatitis virus infections. Previous studies have not explored the contribution of each risk factor.
To determine the contribution of each of these risk factors to hepatocellular carcinoma, Dimitrios Trichopoulos, Ph.D., of the Harvard School of Public Health, and colleagues, used data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which was established to investigate the role of biological, dietary, lifestyle and environmental factors in the etiology of cancer and other diseases in several European countries. The researchers matched 115 patients with hepatocellular carcinoma to 229 control subjects.
The researchers found that 47.6% of the cases of hepatocellular carcinoma in the cohort were associated with smoking, 20.9% with hepatitis C, 16.1% with obesity, 13.2% with hepatitis B, and 10.2% with heavy alcohol intake. They write, "We have shown that hepatocellular carcinoma, one of the most lethal human cancers, is largely amenable to primary prevention with existing knowledge and technology," noting that "although chronic infection with HBV and/or HCV was the strongest risk factor for hepatocellular carcinoma, tobacco smoking was responsible for more cases of hepatocellular carcinoma than either or both these viruses in the population."
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