Korean J Geriatr Gerontol.  2023 Apr;24(1):41-47. 10.15656/kjcg.2023.24.1.41.

Occurrence of Liver Cancer in People without Traditional Risk Factors

• Choi J
• Park J
• Lee JK
• Cho K

• KMID: 2566352
• DOI: http://doi.org/10.15656/kjcg.2023.24.1.41

Abstract

Background
According to the 2019 National Cancer Registry Statistics in Korea, the age-standardized incidence of liver cancer ranked seventh among all types of cancer in Korea. We analyzed the factors associated with the population-wide occurrence of liver cancer, excluding traditional high-risk groups such as those with hepatitis B, hepatitis C, and liver cirrhosis.
Methods
Among the 8,706,575 people who participated in the National Health Examination in 2009, the data for 7,254,458 people were selected and analyzed, excluding those with the traditional risk factors of hepatitis B, hepatitis C, and liver cirrhosis. The incidence of liver cancer during the 2009-2018 period and differences according to demographic factors, lifestyles, and metabolic comorbidities were analyzed. The hazard ratios (HRs) of liver cancer for these variables were analyzed by Cox regression analysis.
Results
During the 10-year follow-up period, liver cancer occurred in 50,277 (0.69%) out of 7,254,458 cases. People aged 80 and above had the highest HR, 4.016 (95% confidence interval, 3.906-4.125, P＜.0001). The HRs of the groups with impaired fasting glucose and diabetes mellitus were 1.047 (1.007-1.087, P=.035) and 1.193 (1.160-1.227, P＜.0001), respectively. The lifestyle factors such as high-risk drinking (1.310, 1.260-1.361, P＜.0001) and current smoking (1.097, 1.066-1.129, P＜.0001) were positively associated with the occurrence of liver cancer.
Conclusion
We identified the factors associated with the occurrence of liver cancer besides viral hepatitis and liver cirrhosis. The results indicate that public guidelines are needed to prevent liver cancer. Further prospective studies that include genetic factors and other omitted variables are required.

Keyword

Hepatocellular carcinoma; Incidence of liver cancer; Risk analysis