Korean J Med.  2001 Feb;60(2):123-130.

Risk factors for hepatocellular carcinoma in Korea

• Ahn SH
• Han KH
• Youn YH
• Hong SP
• Paik YH
• Chon CY
• Moon YM
• Song KJ
• Kim DK
• Suh I

Abstract

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common neoplasms in the world. Although screening test for HCC has been performed, the high risk factors were not well evaluated in Korea. This study was undertaken to evaluate the risk factors of HCC development in Korea.
METHODS
We studied a total of 2,020 patients who visited Yonsei University Medical Center for regular check-up including ultrasonography (US) and alpha-fetoprotein (AFP) from January 1990 to December 1998. All the detailed data of clinical parameters were obtained by our self-exploited data base system prospectively and analyzed by SAS program.
RESULTS
Among 2,020 subjects, 1295 were male and 725 were female (mean age, M: 47 years, F: 50 years). 117 (5.8%) out of 2,020 subjects developed HCC during follow-up period (33months). Annual detection rate of HCC was 1.64%. The independent risk factors by univariate analysis were liver cirrhosis, chronic hepatitis, hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, old age (over 40 years old), heavy alcoholics, severe liver parencymal echogenic pattern in US, initial level of serum AFP (>20 ng/mL) or alanine aminotransferase (ALT) (>40 IU/L). Multivariate analysis with a proportional hazards model showed liver cirrhosis (p=0.000), chronic hepatitis (p=0.014), HCV infection (p=0.007), HBV infection (p=0.049), and old age over 40 years old (p=0.000) to be significant risk factors for HCC. We also found that the more risk factors, the higher HCC development. The development of HCC might not be related to history of smoking, family history of HCC, previous therapy such as interferon (IFN), diet, drugs, and transfusion.
CONCLUSION
Screening test for early detection of HCC should be reconsidered according to the relative risk rate of these risk factors.

Keyword

Carcinoma; Hepatocellular; Risk factors; Screening

MeSH Terms

Academic Medical Centers
Adult
Alanine Transaminase
Alcoholics
alpha-Fetoproteins
Carcinoma, Hepatocellular*
Diet
Female
Follow-Up Studies
Hepacivirus
Hepatitis B virus
Hepatitis, Chronic
Humans
Interferons
Korea*
Liver
Liver Cirrhosis
Male
Mass Screening
Multivariate Analysis
Proportional Hazards Models
Prospective Studies
Risk Factors*
Smoke
Smoking
Ultrasonography
Alanine Transaminase
Interferons
Smoke
alpha-Fetoproteins