Hepatitis C infection identified as leading risk factor for HCC

Posted on HemOncToday.com January 19, 2012

Yang JD. Mayo Clin Proc. 2012;87:9-16.

Liver-scarring diseases such as cirrhosis from alcohol consumption continue to present a high risk for the development hepatocellular carcinoma, but hepatitis C infection has been identified as the leading risk factor, according study results published in Mayo Clinic Proceedings.

Researchers analyzed trends in incidence, etiology and treatment of liver cancer among residents in Olmsted County, Minn. Using medical records from a community-wide medical record linkage system, they identified 104 residents aged older than 20 years diagnosed with hepatocellular carcinoma (HCC) from 1976 to 2008.

Divided into three eras based on time of diagnosis, the analysis demonstrated that the age- and sex-adjusted incidence rate for HCC in Olmsted County was 3.5/100,000 person-years for the first era (1976-1990), 3.8/100,000 for the second era (1991-2000) and 6.9/100,000 for the third era (2001-2008).

In the first era, alcohol use was identified as the most common cause of HCC, with no diagnoses of hepatitis C virus (HCV). In the second era, however, the percentage of HCCs attributable to HCV had risen to 25%, including 7.1% who were observed to have joint HCV and alcohol use as causes of HCC. In the third era, 21 of 47 patients diagnosed with HCC had evidence of chronic HCV infection.

The increase in the proportion of HCV most significantly affected patients aged 50 to 59 years — seven of eight exhibited HCV in the most recent era. Additionally, coexisting alcoholic liver disease was common in HCV patients who developed HCC at an age younger than 60 years: Six of eight HCV patients aged younger than 60 years had coexisting alcoholic liver disease, whereas only one (6.3%) of 16 patients aged 60 years or older had this coexisting disease (P,.01).

“The liver scarring from hepatitis C can take 20 to 30 years to develop into cancer,” W. Ray Kim, MD, principal investigator in the study, said in a press release. “We’re now seeing cancer patients in their 50s and 60s who contracted hepatitis C 30 years ago and didn’t even know they were infected.”

Disclosure: Study researcher Lewis R. Roberts, MBChB, PhD, reports receiving research grants from Bristol-Myers Squibb and MDS Nordion.

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