Combined effect of socioeconomic status, viral hepatitis, and lifestyles on hepatocelluar carcinoma risk in Korea

• Published in: British Journal of Cancer Vol. 103; no. 5; pp. 741 - 746
• Main Authors: Yun, E H, Lim, M K, Oh, J-K, Park, J H, Shin, A, Sung, J, Park, E-C
• Format: Journal Article
• Language: English
• Published: London Springer Science and Business Media LLC 24.08.2010; Nature Publishing Group UK; Nature Publishing Group
• Subjects: 692/499; 692/699/1503/1504/1610; 692/699/1503/1607/234/2513; 692/700/478/174; Adult; Age; Aged; Alcohol Drinking; Alcohol Drinking - adverse effects; Alcohol use; Alcoholism; Antigens; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Carcinoma, Hepatocellular; Carcinoma, Hepatocellular - etiology; Cigarettes; Drug Resistance; Epidemiology; Family income; Female; Gender; Health care; Hepatitis B; Hepatitis B - complications; Hepatitis C; Hepatitis C - complications; Hepatitis, Viral, Human; Hepatitis, Viral, Human - complications; Hospitals; Human viral diseases; Humans; Infectious diseases; Korea; Korea - epidemiology; Life Style; Liver cancer; Liver Neoplasms; Liver Neoplasms - etiology; Low income groups; Male; Medical research; Medical sciences; Middle Aged; Molecular Medicine; Oncology; Preventive medicine; Questionnaires; Risk; Risk factors; Smoking; Smoking - adverse effects; Social Class; Socioeconomic factors; Tumors; Viral diseases; Viral hepatitis; Asia; Korea; South Korea; North America; Africa; Korea, Rep; alcohol; viral hepatitis; liver cancer; socioeconomic status; BMI; Carcinoma; Socioeconomic status; Ethanol; Hepatic disease; Malignant tumor; Infection; Alcoholic beverage; Liver cancer; Body mass index; Viral hepatitis; Cancerology; Viral disease; Risk factor; Digestive diseases; Cancer; Life style
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/sj.bjc.6605803

Background: The independent and combined effects of socioeconomic status (SES), viral hepatitis, and other lifestyle factors on hepatocellular carcinoma (HCC) risk have not been investigated among Koreans. Methods: From the National Cancer Center Hospital, 207 HCC cases and 828 age- and gender-matched controls aged 30 years or older were recruited. Socio-demographic and behavioural risk factors were ascertained through personal interview, and infection with hepatitis B and C viruses was determined by their serologic markers. Multivariate logistic regression and synergy index methods were applied for statistical analysis. Results: HB surface antigen (HbsAg) and anti-HCV-positive rates were 149.3 and 185.1 times higher in cases than controls, respectively. Lifetime alcohol consumption (odds ratio: 2.96, 95% CI: 1.29–6.79), cigarette smoking (OR: 3.53, 95% CI: 1.31–9.52), and family income (OR: 17.07, 95% CI: 4.27–68.25) were independently associated with the risk of HCC in subjects with or without viral hepatitis. Synergistic interaction on HCC risk was observed between low income and HBsAg positivity (SI: 3.12, 95% CI: 1.51–6.47) and between low income and heavy alcohol intake (SI: 2.93, 95% CI: 1.24–6.89). Conclusion: The inverse association with SES suggests SES as an independent and synergistic predictor of HCC. Heavy alcohol intake also showed a combined effect with low SES on HCC risk.