Occupational Exposure and Liver Cancer in Women: Results of the Multicentre International Liver Tumour Study (MILTS)

Abstract

The association of occupational variables and hepatocellular cancer (HCC) is discussed with particular reference to women, as little research has been undertaken on their behalf. This paper reports the results of an international case-control study concerning women and involves 317 cases of HCC and 1789 controls. Working in the chemical industry was shown to have only a marginally significant risk associated with HCC: adjusted odds ratio (OR) and 95% confidence interval 2.37 (1.04-5.41). Other non-significantly elevated ORs were observed in the pharmaceutical, plastics, PVC-producing, farming and butchery industries. Little consistency was found among the risk estimates for HCC, based on three different analytical approaches. None of the analyses showed a linear trend of risk with increasing duration of exposure. However, the numbers of exposed cases and controls were small for many of the occupations and therefore the study power and precision were low. We failed to find important and consistent evidence for a relationship between HCC in women and occupational variables. However, even weak evidence of occupational risk warrants careful consideration in future studies.

Epidemiologic risk factors of hepatocellular carcinoma in a rural region of Egypt

“…Recently, a case-control study suggested a mild association between metal machining jobs and HCC among those without viral infection [53]. Nevertheless, a multicenter international liver tumor study failed to establish the association between occupational exposures and liver cancer among women, even though the viral factor was carefully considered and occupation-exposure matrix was constructed [54]. Taken together, those international studies from North American or European countries were less capable to efficiently assess the interplay between viral profile and occupational or environmental exposures to the risk of HCC due to the low prevalence of HBV/HCV.…”

Oral contraception and the risk of hepatocellular carcinoma

“…In nine of the 12 studies, structured questionnaires were used in interviews or by mail [11,[14][15][16][18][19][20][21][22], whereas three studies did not specify how interviews were conducted [12,13,17]. Participants alive at the time of data collection were interviewed in person in eight of the studies [12,14,17,[20][21][22].…”

“…Participants alive at the time of data collection were interviewed in person in eight of the studies [12,14,17,[20][21][22]. Four studies added an in person interview or mailed questionnaire of next of kin or physician if the study participant had died [11,13,15,16]. Two studies used chart abstraction to gain additional information [11,16].…”

“…Several studies, generally using small sample sizes, investigated a possible link between OC and HCC. The findings of these studies have been inconsistent and either included an increased risk of HCC [14,16,17,22] or no association [11][12][13]15,[18][19][20][21]. Therefore, we conducted this review and meta-analysis to critically examine the epidemiological evidence for the association between OC use and HCC risk.…”

Primary liver cancer and occupation in men: A case-control study in a high-incidence area in northern Italy

“…So far, only 2 epidemiologic studies aimed at investigating occupational exposures as risk factors for PLC took also into account alcohol consumption and viral infections. 11,12 In fact, the literature reports relatively few relevant studies and most of them were conducted before valid biologic markers for HCV infection became available for large-scale investigations. [13][14][15][16][17] The aim of our study was to evaluate the association between occupation and PLC.…”