American Journal of Epidemiology Vol. 151, No. 2: 131-139
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
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Prospective Study of Hepatitis B and C Viral Infections, Cigarette Smoking, Alcohol Consumption, and Other Factors Associated with Hepatocellular Carcinoma Risk in Japan
1Department of Community Health Science, Saga Medical School Saga, Japan
2Department of Internal Medicine, Saga Medical School Saga, Japan
3Saga Prefectural Medical Association Saga, Japan
4Committee on Liver Disease Control K. Town, Saga, Japan
5Present address: Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
Reprint requests to Dr. Mitsuru Mori, Department of Public Health, Sapporo Medical University School of Medicine, South 1, West 17, Chuoku, Sapporo, Japan 060–8556.
This community-based prospective study examined the effects of viral infections and lifestyle habits on hepatocellular carcinoma (HCC) risk in Japan. A baseline survey was conducted for 981 males and 2,078 females in June 1992 and evaluated hepatitis B surface antigen, second-generation hepatitis C virus antibody, and history of cigarette smoking and habitual alcohol consumption. By March 1997, 14 males and 8 females had been newly diagnosed with HCC. After controlling for gender and age by using the Cox model, the authors found that positivity for hepatitis B surface antigen (hazard ratio = 7.28, 95% confidence interval: 1.62, 32.61; p < 0.01) and positivity for high-titer hepatitis C virus antibody (hazard ratio = 40.38, 95% confidence interval: 11.71, 139.21; p < 0.001) were significantly associated with HCC risk, although a history of smoking or alcohol consumption was not significantly related to risk. There was a significant interaction on an additive scale for the risk of HCC development between high-titer hepatitis C virus antibody status and a history of smoking (p < 0.05) in spite of no significant interaction on a multiplicative scale. Although preventing the transmission of hepatitis viruses is most important for reducing the risk of HCC, intervention regarding lifestyle habits such as cigarette smoking should not go unheeded. Am J Epidemiol 2000;151:131–9.
alcohol drinking; carcinoma; hepatocellular; cohort studies; hepatitis B virus; hepatitis C; risk assessment; smoking
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