Dietary habits and risk of hepatocellular carcinoma among hepatitis B surface antigen carriers: A prospective cohort study in China

Abstract

ObjectiveIn this prospective cohort study, we aimed to evaluate the association between dietary habits and the risk of developing hepatocellular carcinoma (HCC) in hepatitis B surface antigen (HBsAg)‐positive carriers in Qidong, an hepatitis B virus (HBV)‐epidemic area in China.MethodsA total of 3199 HBsAg carriers aged 30‐70 years in a prospective cohort in Qidong, China from 2007 to 2011 were included in the study. At baseline, all participants self‐reported their dietary habits in a questionnaire interview. A follow‐up check‐up was performed every 6 months to identify HCC cases until November 2017. Cox’s regression analysis and an interaction analysis were performed to estimate the relative risks of HCC in terms of baseline diet.ResultsAmong 3199 HBsAg‐positive participants, 270 developed HCC (143.86/100 000 person‐years [PYs]). Compared with participants who rarely consume garlic, the risk of HCC in those who consumed it ≥ once per week decreased along with the increase in frequency (HR = 1.00, 0.90 and 0.62 in those who consumed it rarely vs those who consumed it 1‐6 times per week and ≥ 7 times per week, respectively). This study found a synergistic effect between garlic and tea consumption on the risk of HCC (P = 0.039 for a multiplicative interaction).ConclusionsHBsAg carriers should improve their diet. Regular consumption of garlic and tea drinking may reduce the HCC incidence in HBsAg carriers.

Allium Vegetables, Garlic Supplements, and Risk of Cancer: A Systematic Review and Meta-Analysis

“…As shown in Figure 1 , in the pooled analysis of the 22 studies ( 9 , 18 – 23 , 25 – 30 , 32 , 34 , 36 – 42 ) with 25 reports on allium vegetable consumption, no significant association was observed between a high consumption of allium vegetables and cancer risk (RR, 0.97; 95% CI, 0.92–1.03; P = 0.356; I 2 = 22.0%; P h = 0.161). Garlic supplements were also not found to be significantly associated with an increased risk of cancer (RR, 0.97; 95% CI, 0.84–1.12; P = 0.705; I 2 =50.5%; P h = 0.027) in a random-effects model involving a pooled analysis of 10 studies ( 9 , 10 , 19 , 21 , 22 , 24 , 31 , 33 , 35 , 38 ) with 11 reports ( Figure 2 ).…”

“…A random-effects, dose-response meta-analysis was performed to precisely assess the relationship between allium vegetable consumption and risk of cancer. A total of 14 studies ( 9 , 19 , 21 – 23 , 26 , 29 , 30 , 32 , 38 – 42 ) with 20 reports were included. We did not find a curvilinear association between allium vegetable consumption and risk of cancer ( P = 0.958 for nonlinearity; P = 0.907 for linearity) ( Figure 3 ).…”

“…In an analysis of individual allium vegetables, garlic intake was investigated in seven studies ( 9 , 18 , 20 , 30 , 38 , 41 , 42 ) with eight reports, which showed no association with cancer risk (RR, 0.93; 95% CI, 0.79–1.09). An analysis of eight studies ( 19 , 21 – 23 , 26 , 30 , 36 , 40 ) with nine reports related to onion consumption showed that a high amount of onion consumption was not associated with cancer risk (RR, 0.96; 95% CI, 0.90–1.03).…”

“…It is worth noting that previous meta-analyses always combined garlic and garlic supplements, however, garlic supplements have been proven to be significantly associated with an increased risk of certain cancer types, including colorectal cancer ( 8 ). In the current meta-analysis, we conducted a subgroup analysis exploring the role of garlic consumption on cancer prevention without garlic supplements, finding no association between higher garlic consumption and reduced cancer risk after pooling the results of eight reports, including five on colorectal cancer ( 9 , 18 – 20 , 38 ) (1,2), one on stomach cancer [Kim, 2018 ( 41 )], one on prostate cancer [Kirsh, 2007 ( 30 )], and one on liver cancer[Yu, 2020 ( 42 )]. It is worth exploring whether the addition of retrospective studies, such as case-control studies, would have led to different results.…”