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Br J Cancer. 2018 Apr;118(7):1005-1012. doi: 10.1038/s41416-018-0007-z. Epub 2018 Mar 9.

Tobacco, alcohol use and risk of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: The Liver Cancer Pooling Project.

Author information

1
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. jessica.petrick@nih.gov.
2
Epidemiology Research Program, American Cancer Society, Atlanta, GA, USA.
3
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
4
Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
5
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
6
Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
7
Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
8
Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
9
VA Boston Healthcare System, Boston, MA, USA.
10
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
11
Slone Epidemiology Center at Boston University, Boston, MA, USA.
12
Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
13
Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
14
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
15
Department of Medicine and Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
16
Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY, USA.
17
Department of Population Health, New York University School of Medicine, New York, NY, USA.

Abstract

BACKGROUND:

While tobacco and alcohol are established risk factors for hepatocellular carcinoma (HCC), the most common type of primary liver cancer, it is unknown whether they also increase the risk of intrahepatic cholangiocarcinoma (ICC). Thus, we examined the association between tobacco and alcohol use by primary liver cancer type.

METHODS:

The Liver Cancer Pooling Project is a consortium of 14 US-based prospective cohort studies that includes data from 1,518,741 individuals (HCC n = 1423, ICC n = 410). Multivariable-adjusted hazards ratios (HRs) and 95% confidence intervals (CI) were estimated using proportional hazards regression.

RESULTS:

Current smokers at baseline had an increased risk of HCC (hazard ratio (HR) = 1.86, 95% confidence interval (CI): 1.57-2.20) and ICC (HR = 1.47, 95% CI: 1.07-2.02). Among individuals who quit smoking >30 years ago, HCC risk was almost equivalent to never smokers (HR = 1.09, 95% CI: 0.74-1.61). Compared to non-drinkers, heavy alcohol consumption was associated with an 87% increased HCC risk (HR≥7 drinks/day = 1.87, 95% CI: 1.41-2.47) and a 68% increased ICC risk (HR≥5 drinks/day = 1.68, 95% CI: 0.99-2.86). However, light-to-moderate alcohol consumption of <3 drinks/day appeared to be inversely associated with HCC risk (HR>0-<0.5 drinks/day = 0.77, 95% CI: 0.67-0.89; HR>0.5-<1 drinks/day = 0.57, 95% CI: 0.44-0.73; HR1-<3 drinks/day = 0.71, 95% CI: 0.58-0.87), but not ICC.

CONCLUSIONS:

These findings suggest that, in this relatively healthy population, smoking cessation and light-to-moderate drinking may reduce the risk of HCC.

PMID:
29520041
PMCID:
PMC5931109
[Available on 2019-04-03]
DOI:
10.1038/s41416-018-0007-z

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