Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: A prospective cohort study in Korea

Yi, Sang‐Wook; Choi, Ja-Sung; Yi, Jee‐Jeon; Lee, Yong-Ho; Han, Ki Jun

doi:10.1002/cncr.31406

Cited by 75 publications

(67 citation statements)

References 32 publications

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“…The evidence for protection given by moderate alcohol intake on NAFLD has however been challenged ( Table 2) [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63]. In the Italian Dionysos study, a study exploring the prevalence of liver disease in the general population of two Italian towns [49], alcohol use was associated with both fatty liver incidence and remission when graded for any 20 g/day in both men and women.…”

Section: Moderate Alcohol Consumption and The Liver Within And Outsidmentioning

confidence: 99%

Moderate Alcohol Intake in Non-Alcoholic Fatty Liver Disease: To Drink or Not to Drink?

et al. 2019

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Nonalcoholic fatty liver disease (NAFLD) is defined by hepatic steatosis in the presence of alcohol intake within safe limits, defined by guidelines of scientific associations (usually 20 g or 2 units/day in women, 30 g or 3 units in men). The diagnosis is usually followed by medical counseling of total abstinence, in order to prevent disease progression. This policy has been challenged by epidemiological studies, suggesting that the risk of liver disease and disease progression is lower in modest drinkers than in total abstainers. We revised the literature on the effects of modest alcohol intake on disease burden. Epidemiological data may suffer from several potential biases (recall bias for retrospective analyses, difficulties in the calculation of g/day), limiting their validity. Prospective data suggest that NAFLD patients with regular alcohol intake, although within the safe thresholds, are at higher risk of liver disease progression, including hepatocellular carcinoma; a detrimental effect of modest alcohol drinking is similarly observed in liver disease of viral etiology. Alcohol intake is also a risk factor for extrahepatic cancers, particularly breast, oral, and pharyngeal cancers, with gender difference and no floor effect, which outweigh the possible beneficial effects on cardiovascular system, also derived from retrospective studies. Finally, the negative effects of the calorie content of alcohol on dietary restriction and weight loss, the pivotal intervention to reduce NAFLD burden, should be considered. In summary, the policy of counseling NAFLD patients for alcohol abstinence should be maintained.Nutrients 2019, 11, 3048 2 of 23 equals mortality in alcohol users) for an average alcohol consumption of approximately 25-30 g in women and 40 g in men [4].All NAFLD studies explicitly report the exclusion of subjects with alcohol intake at risk, defined according to pre-specified criteria, and most clinicians suggest total abstinence from alcohol as therapeutic measure for prevention NAFLD and/or disease progression. More than a decade ago a few epidemiological studies reported an inverse association between moderate alcohol consumption (within presumably safe limits) and the prevalence of NAFLD in the population [5,6], pointing to a favorable effect of moderate alcohol use extending from the cardiovascular system to the setting of metabolic liver disease. This raised a lot of debate on the correct dietary and lifestyle treatment of NAFLD, which has not settled yet. Do we need to counsel our NAFLD patients for total alcohol abstinence to prevent disease progression?This narrative review is intended to summarize the evidence linking moderate alcohol intake with NAFLD, starting from difficulties in the correct assessment of alcohol intake. The conclusions are based on the experience of authors and the general effects of alcohol on the liver and outside the liver, in the hope to generate a common health policy among healthcare professionals. Literature Search

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Section: Moderate Alcohol Consumption and The Liver Within And Outsidmentioning

confidence: 99%

Moderate Alcohol Intake in Non-Alcoholic Fatty Liver Disease: To Drink or Not to Drink?

et al. 2019

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“…Alternatively, the reduced prevalence of advanced fibrosis among women versus men may be due to a lower frequency of cofactors for liver disease progression, such as alcohol use. (13)(14)(15)…”

Section: Natural History Of Hcv Among Womenmentioning

confidence: 99%

Hepatitis C in Pregnancy: A Unique Opportunity to Improve the Hepatitis C Cascade of Care

Kushner

Terrault

2018

Hepatol Commun

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“…That is one of the motivations for our study. 1 For example, to our knowledge, evidence has been lacking regarding whether smoking increases the risk of HCC independent of HBV and HCV infection, or in the HBV-negative and HCV-negative populations. 2 Our study included all traditional risk factors with the exception of aflatoxin.…”

Section: Reply To Risk Factors For Hepatocellular Carcinomamentioning

confidence: 99%

“…An article written by Yi et al recently published in Cancer reported that current smoking was associated with an increased risk of developing hepatocellular carcinoma irrespective of viral hepatitis (hazard ratio, 1.26; 95% confidence interval, 1.15-1.38). 1 Currently, major risk factors for hepatocellular carcinoma worldwide are chronic hepatitis B infection, chronic hepatitis C infection, diabetes mellitus, heavy alcohol consumption, nonalcoholic fatty liver disease, and aflatoxin. [2][3][4][5][6] Without these traditional risk factors, the risk of developing hepatocellular carcinoma is relatively low.…”

mentioning

confidence: 99%