Family history of liver cancer and hepatocellular carcinoma.

Turati F, Edefonti V, Talamini R, Ferraroni M, Malvezzi M, Bravi F, Franceschi S, Montella M, Polesel J, Zucchetto A, La Vecchia C, Negri E, Decarli A.

Source

Dipartimento di Epidemiologia, Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; Dipartimento di Medicina del Lavoro, Università degli Studi di Milano, Milan, Italy.

Abstract

Familial clustering of hepatocellular carcinoma (HCC) has been reported frequently among eastern Asiatic countries, where hepatitis B infection is common. Little is known about the relationship between family history of liver cancer and HCC in Western populations. We carried out a case-control study in Italy, involving 229 HCC cases and 431 hospital controls. Data on family history were summarized through a binary indicator (yes/no) and a family history score (FHscore), considering selected family characteristics. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were obtained from unconditional multiple logistic regression models including terms for age, sex, study center, education, tobacco smoking, alcohol drinking, hepatitis B surface antigen and/or anti-hepatitis C virus positivity. We also performed a meta-analysis on family history and liver cancer updated to April 2011 using random-effects models. After adjustment for chronic infection with hepatitis B/C viruses, family history of liver cancer was associated to HCC risk, when using both the binary indicator (OR=2.38, 95% CI, 1.01-5.58) and the FHscore, with increasing ORs for successive score categories. Compared to subjects without family history and no chronic infection with hepatitis B/C viruses, the OR for those exposed to both risk factors was 72.48 (95% CI, 21.92-239.73). In the meta-analysis, based on 9 case-control and 4 cohort studies, for a total of about 3600 liver cancer cases, the pooled relative risk for family history of liver cancer was 2.50 (95% CI, 2.06-3.03). CONCLUSION: A family history of liver cancer increases HCC risk, independently of hepatitis. The combination of family history of liver cancer and hepatitis B/C serum markers is associated to an over 70-fold elevated HCC risk. (HEPATOLOGY 2011.).
Copyright © 2011 American Association for the Study of Liver Diseases.