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Cigarette smoking, alcohol drinking, hepatitis B, and risk for hepatocellular carcinoma in Korea.
J Natl Cancer Inst 2004; 96(24):1851-6JNCI

Abstract

BACKGROUND

Liver cancer is one of the most common cancers worldwide, particularly in Asia and Africa, where infectious hepatitis and aflatoxin exposures are common. We conducted a prospective cohort study of liver cancer in Korea to assess the independent effects and interactions of smoking, alcohol consumption, and hepatitis B on risk of mortality from hepatocellular carcinoma.

METHODS

From a total of 1,283,112 men and women free of cancer at baseline, 3807 died from liver cancer during follow-up from 1993 to 2002. All participants reported their smoking and alcohol consumption, and hepatitis B surface antigen (HBsAg) status was documented for 47.2% of the participants. Relative risk and 95% confidence intervals (CIs) of mortality from hepatocellular carcinoma were calculated using proportional hazards models adjusted for age, alcohol drinking, diabetes, and HBsAg status.

RESULTS

Current smoking was associated with increased risk of mortality from hepatocellular carcinoma in men (RR = 1.4; 95% CI = 1.3 to 1.6) but not women (RR = 1.1; CI = 0.8 to 1.7). The relative risk of mortality from hepatocellular carcinoma for male HBsAg carriers was 24.3 (95% CI = 21.9 to 26.9) times that in HBsAg-negative males; the relative risk for HBsAg-positive women was 54.4 (95% CI = 24.8 to 119.5). Heavy alcohol drinking was associated with hepatocellular carcinoma mortality risk in the subgroup of men who were tested for HBsAg (RR =1.5; 95% CI = 1.2 to 2.0). There was no interaction among smoking, alcohol drinking, and HBsAg in terms of hepatocellular carcinoma mortality.

CONCLUSION

Cigarette smoking, heavy alcohol consumption, and HBsAg were independently associated with increased risk of mortality from hepatocellular carcinoma but did not interact synergistically. The relatively higher increase in mortality from hepatocellular carcinoma in HBsAg-seropositive women compared with men merits further research.

Authors+Show Affiliations

Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea. jsunha@yumc.yonsei.ac.krNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15601641

Citation

Jee, Sun Ha, et al. "Cigarette Smoking, Alcohol Drinking, Hepatitis B, and Risk for Hepatocellular Carcinoma in Korea." Journal of the National Cancer Institute, vol. 96, no. 24, 2004, pp. 1851-6.
Jee SH, Ohrr H, Sull JW, et al. Cigarette smoking, alcohol drinking, hepatitis B, and risk for hepatocellular carcinoma in Korea. J Natl Cancer Inst. 2004;96(24):1851-6.
Jee, S. H., Ohrr, H., Sull, J. W., & Samet, J. M. (2004). Cigarette smoking, alcohol drinking, hepatitis B, and risk for hepatocellular carcinoma in Korea. Journal of the National Cancer Institute, 96(24), pp. 1851-6.
Jee SH, et al. Cigarette Smoking, Alcohol Drinking, Hepatitis B, and Risk for Hepatocellular Carcinoma in Korea. J Natl Cancer Inst. 2004 Dec 15;96(24):1851-6. PubMed PMID: 15601641.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cigarette smoking, alcohol drinking, hepatitis B, and risk for hepatocellular carcinoma in Korea. AU - Jee,Sun Ha, AU - Ohrr,Heechoul, AU - Sull,Jae Woong, AU - Samet,Jonathan M, PY - 2004/12/17/pubmed PY - 2004/12/29/medline PY - 2004/12/17/entrez SP - 1851 EP - 6 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 96 IS - 24 N2 - BACKGROUND: Liver cancer is one of the most common cancers worldwide, particularly in Asia and Africa, where infectious hepatitis and aflatoxin exposures are common. We conducted a prospective cohort study of liver cancer in Korea to assess the independent effects and interactions of smoking, alcohol consumption, and hepatitis B on risk of mortality from hepatocellular carcinoma. METHODS: From a total of 1,283,112 men and women free of cancer at baseline, 3807 died from liver cancer during follow-up from 1993 to 2002. All participants reported their smoking and alcohol consumption, and hepatitis B surface antigen (HBsAg) status was documented for 47.2% of the participants. Relative risk and 95% confidence intervals (CIs) of mortality from hepatocellular carcinoma were calculated using proportional hazards models adjusted for age, alcohol drinking, diabetes, and HBsAg status. RESULTS: Current smoking was associated with increased risk of mortality from hepatocellular carcinoma in men (RR = 1.4; 95% CI = 1.3 to 1.6) but not women (RR = 1.1; CI = 0.8 to 1.7). The relative risk of mortality from hepatocellular carcinoma for male HBsAg carriers was 24.3 (95% CI = 21.9 to 26.9) times that in HBsAg-negative males; the relative risk for HBsAg-positive women was 54.4 (95% CI = 24.8 to 119.5). Heavy alcohol drinking was associated with hepatocellular carcinoma mortality risk in the subgroup of men who were tested for HBsAg (RR =1.5; 95% CI = 1.2 to 2.0). There was no interaction among smoking, alcohol drinking, and HBsAg in terms of hepatocellular carcinoma mortality. CONCLUSION: Cigarette smoking, heavy alcohol consumption, and HBsAg were independently associated with increased risk of mortality from hepatocellular carcinoma but did not interact synergistically. The relatively higher increase in mortality from hepatocellular carcinoma in HBsAg-seropositive women compared with men merits further research. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/15601641/Cigarette_smoking_alcohol_drinking_hepatitis_B_and_risk_for_hepatocellular_carcinoma_in_Korea_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djh334 DB - PRIME DP - Unbound Medicine ER -