Cancer incidence among alcoholic liver disease patients in Finland: A retrospective registry study during years 1996–2013

Abstract

Both alcohol abuse and liver cirrhosis are known risk factors for various cancers. This article was aimed to assess the long-term risk of malignancies among patients with severe alcoholic liver disease (ALD), i.e., alcoholic liver cirrhosis and alcoholic hepatitis. A cohort of 8,796 male and 3,077 female ALD patients from 1996 to 2012 was identified from the Finnish National Hospital Discharge Register. This nationwide cohort was combined with the data from the Finnish Cancer Registry for incidence of malignancies during the years 1996-2013. The cancer cases diagnosed were compared with the number of cancers in the general population. The number of malignancies in our cohort was 1,052 vs. 368 expected. There was statistically significant excess of cancers of the liver, (standardized incidence ratio [SIR] 59.20; 95% CI 53.11-65.61), pancreas (SIR 3.71; 95% CI 2.72-4.94), pharynx (SIR 9.25; 95% CI 6.05-13.56), mouth (SIR 8.31;29), oesophagus (SIR 7.92; 95% CI 5.49-11.07), tongue (SIR 7,21; 95% CI 3.60-12.89), larynx (SIR 5.20; 95% CI 2.77-8.89), lung (SIR 2.77; 95% CI 2.27-3.32), stomach (SIR 2.76; 95% CI 1.79-4.07), kidney (SIR 2.69; 95% CI 1.84-3.79) and colon (SIR 2.33; 95% CI 1.70-3.11). There was no decreased risk of any cancer among ALD patients. Severe ALD is associated with markedly increased risk of malignancies. The risk is especially high for hepatocellular carcinoma, but also significantly increased for cancers of the upper aerodigestive tract, pancreas and kidneys, and warrants cancer surveillance in selected cases.

Decreasing incidence of cancer after liver transplantation—A Nordic population-based study over 3 decades

“…2 It is possible that cancers are still detected at more advanced stages, thus leading to high mortality despite improved treatment efforts. 45 The slightly higher SIR for pancreas cancer in the present study may be related to the elevated SIRs of these subgroups, especially as PSC is one of the main indications for LT in the Nordic countries. Alcoholic cirrhosis patients may have concomitant chronic pancreatitis-like lesions, which might be a source for the elevated pancreas cancer risk in this group.…”

“…The risk for pancreas cancer was recently found to be elevated also among alcoholic liver disease patients who have not been transplanted. 45 The slightly higher SIR for pancreas cancer in the present study may be related to the elevated SIRs of these subgroups, especially as PSC is one of the main indications for LT in the Nordic countries. As compared to other solid organ transplantations, LT patients seem to have slightly higher incidence of pancreatic cancer than kidney 28,46 or heart and lung 20 transplantation patients.…”

Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission

“…A large Finnish study identified increased incidence of multiple types of cancer in addition to HCC among people with severe ALD and it is possible that our study lacked power to detect these associations (28). NAFLD has been associated with increased risk of colonic cancer (29), adenomatous polyps (30) and right sided colonic tumours (31).…”

Synchronous colorectal carcinoma: predisposing factors and characteristics

“…The illnesses investigated, including hypertension, cardiac disease, CVA, asthma, diabetes, hepatitis, thyroid disease and liver cirrhosis, were reported to be risk factors for sCRC. Some medical illnesses, such as hypertension [23,25,26], diabetes mellitus [24,[26][27][28][29][30][31] and liver cirrhosis [32,33], have been demonstrated to be associated with the development of colon adenoma and cancer. Certain types of antihypertensive and antidiabetic medications used for controlling these illnesses may contribute to this association [28,34].…”