Prospective Study of Hepatitis B and C Viral Infections, Cigarette Smoking, Alcohol Consumption, and Other Factors Associated with Hepatocellular Carcinoma Risk in Japan
Abstract
This community-based prospective study examined the effects of viral infections and lifestyle habits on hepatocellular carcinoma (HCC) risk in Japan. A baseline survey was conducted for 981 males and 2,078 females in June 1992 and evaluated hepatitis B surface antigen, second-generation hepatitis C virus antibody, and history of cigarette smoking and habitual alcohol consumption. By March 1997, 14 males and 8 females had been newly diagnosed with HCC. After controlling for gender and age by using the Cox model, the authors found that positivity for hepatitis B surface antigen (hazard ratio = 7.28, 95% confidence interval: 1.62, 32.61; p < 0.01) and positivity for high-titer hepatitis C virus antibody (hazard ratio = 40.38, 95% confidence interval: 11.71, 139.21; p < 0.001) were significantly associated with HCC risk, although a history of smoking or alcohol consumption was not significantly related to risk. There was a significant interaction on an additive scale for the risk of HCC development between high-titer hepatitis C virus antibody status and a history of smoking (p < 0.05) in spite of no significant interaction on a multiplicative scale. Although preventing the transmission of hepatitis viruses is most important for reducing the risk of HCC, intervention regarding lifestyle habits such as cigarette smoking should not go unheeded.
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Exposure fractions among prevalent liver cirrhosis cases were used as a proxy for population attributable fractions, following the direct method when relative risk is high.
“We used the resulting predicted exposure fractions among prevalent cases as a proxy for PAFs for liver cirrhosis. This follows from the direct method of approximating PAFs:”
From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [35]
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- Authors
- Mori, M., Hara, M., Wada, I., Hara, T., Yamamoto, K., Honda, M., & Naramoto, J.
- Affiliations
- Saga University (JP)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2000-01-15
- Volume
- 151
- Issue
- 2
- Pages
- 131-139
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2124073571
- Cited by
- 144
- References
- 40
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 4 · 2016: 4 · 2015: 8 · 2014: 7 · 2012: 10
- FWCI
- 7.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Hepatitis B Virus Studies
- Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
- Health Sciences › Medicine › Hepatology › Hepatitis C virus research
- Keywords
- hepatocellular carcinoma, hepatitis B, hepatitis C, hepatitis B surface antigen, anti-HCV antibodies, cigarette smoking, alcohol consumption, lifestyle risk factors, cancer risk
- MeSH terms
- Adult, Aged, Alcohol Drinking, Female, Hepatitis B, Hepatitis B Surface Antigens, Hepatitis C, Carcinoma, Hepatocellular, Humans, Japan, Life Style, Liver Neoplasms, Male, Middle Aged, Prospective Studies, Risk Factors, Smoking, Cohort Studies, Proportional Hazards Models, Hepatitis C Antibodies
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