Long-term change in incidence and risk factors of cirrhosis and hepatocellular carcinoma in Crete, Greece: a 25-year study

Abstract

BackgroundNo sequential long-term data exist for Greece on the etiological evolution and incidence of cirrhosis and hepatocellular carcinoma. Therefore, we studied their etiological evolution over a period of 25 years in the island of Crete.MethodsWe studied 812 cases of cirrhosis (561 male, median age 69 years) and 321 cases of hepatocellular carcinoma (234 male, median age 70 years) from the database of our Center. Cases were classified into five-year periods according to incidence and etiology (hepatitis B, hepatitis C, alcohol, alcohol plus viral, and non-alcoholic fatty liver disease).ResultsOverall, there was an increase in the incidence of hepatocellular carcinoma. A significant fourfold reduction in the incidence of hepatitis C-related cirrhosis was observed, which was degraded from first to third place as a risk factor for cirrhosis. Alcohol gradually became the first risk factor in cirrhosis (1990-94: 36.1%, 2010-14: 52.3%) and carcinoma, while the steepest increase in incidence of cirrhosis and carcinoma was associated with non-alcoholic fatty liver disease.ConclusionsThe incidence of cirrhosis remained constant over the years, but the incidence of hepatocellular carcinoma increased during the last decade. Risk factors for cirrhosis and hepatocellular carcinoma have changed over the past 25 years in Crete. The initial high hepatitis C virus association has significantly decreased, with alcohol now ranking first among risk factors. Non-alcoholic fatty liver disease is continually increasing and is a prominent risk factor for cirrhosis and hepatocellular carcinoma.

Validation of insulin-like growth factor-1 as a prognostic parameter in patients with hepatocellular carcinoma in a European cohort

“…It is estimated that 18 to 33% of the total number of HCCs is caused by past and present alcohol intake in several European countries [ 29 ]. Recently, Karageorgos and colleagues showed a change in incidence and risk factors for cirrhosis and HCC in Crete, with significantly decreased HCV association and alcohol as the top-ranked risk factor [ 30 ]. In a German cohort of 458 HCC patients, chronic alcohol abuse was identified as the leading risk factor in 57.2% [ 31 ].…”

Nonalcoholic Fatty Liver Disease Cirrhosis: A Review of Its Epidemiology, Risk Factors, Clinical Presentation, Diagnosis, Management, and Prognosis

“…The diagnosis of cirrhosis was confirmed by liver biopsy in compensated cirrhosis and clinical evidence in decompensated cirrhosis. They found that NAFLD cirrhosis constituted 15.5% of all cases of cirrhosis [ 17 ]. Hsiang et al reported a retrospective study from a secondary care hospital in South Auckland (New Zealand).…”

The Autophagy Related Gene CHAF1B Is a Relevant Prognostic and Diagnostic Biomarker in Hepatocellular Carcinoma

“…HCC is characterized by a poor prognosis and high aggressivity and is difficult to diagnose early (3). It is widely known that nonalcoholic fatty liver disease, hepatitis C virus, and alcohol abuse are strongly related to the occurrence of HCC (4)(5)(6). Liver biopsy is the most reliable method for diagnosing HCC; however, due to its invasiveness, this method is not suitable for large-scale liver cancer screening (7).…”