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Cited by 118Hepatocellular Carcinoma Treatment and PrognosisHead and Neck Cancer StudiesSmoking Behavior and Cessation

Cigarette smoking as a risk factor for the development of and mortality from hepatocellular carcinoma: an updated systematic review of 81 epidemiological studies

Abdel-Rahman, Omar, Helbling, Daniel, Schöb, Othmar, Eltobgy, Mostafa, Mohamed, Hadeer, Schmidt, Jan, giryes, Anwar, Mehrabi, Arianeb +5 more·2017·Journal of Evidence-Based Medicine
DOI 10.1111/jebm.12270
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Abstract

BACKGROUND AND AIMS: Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide and its incidence has increased during the past decade. While hepatitis B and C virus infections and alcohol were established risk factors, the impact of smoking on the incidence and mortality of HCC was needed to be confirmed. METHODS: We reviewed cohort and case-control studies evaluating the association between cigarette smoking and incidence and mortality of HCC from MEDLINE and Google Scholar. We also checked reference lists of original studies and review articles manually for cross-references up to February 2016. We extracted the relevant information on participant characteristics and study outcomes, as well as information on the methodology of the studies. We also assessed the quality of the included trials using critical appraisal skills program checklists. Meta-analysis was performed by using RevMan 5.3 software. RESULTS: A total of 81 studies were included in the systematic review. Pooled OR for HCC development with current smokers was 1.55 (95% CI: 1.46 to 1.65; P < 0.00001). Pooled OR for HCC development with former smokers was 1.39 (95% CI: 1.26 to 1.52; P < 0.00001) and pooled OR for HCC development with heavy smokers was 1.90 (95% CI: 1.68 to 2.14; P < 0.00001). Pooled OR for the mortality of current smokers with HCC was 1.29 (95% CI: 1.23 to 1.34; P < 0.00001); and for former smokers with HCC, it was 1.20 (95% CI: 1.00 to 1.42; P = 0.04). CONCLUSIONS: Cigarette smoking increases the incidence and mortality of HCC. Further studies are needed to evaluate possible impact of quitting smoking on decreasing this risk.

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Authors
Abdel-Rahman, O., Helbling, D., Schöb, O., Eltobgy, M., Mohamed, H., Schmidt, J., giryes, A., Mehrabi, A., Iype, S., John, H., Tekbas, A., Zidan, A., & Oweira, H.
Affiliations
  • Ain Shams University (EG)
  • Department of Medical Oncology; Gastrointestinal Tumor Center Zurich; Zurich Switzerland
  • Klinik Hirslanden (CH)
  • Heidelberg University (DE)
  • Cambridge University Hospitals NHS Foundation Trust (GB)
  • Department of General, Visceral and Transplant Surgery; University of Heidelberg; Heidelberg Germany
  • Assiut University (EG)
Corresponding author
Abdel-Rahman, Omar
ORCID
Venue
Journal of Evidence-Based Medicine
Publisher
Wiley
Published
2017-09-10
Volume
10
Issue
4
Pages
245-254
ISSN
  • 1756-5383 (ISSN-L)
  • 1756-5391
DOI
10.1111/jebm.12270
OpenAlex
W2752504842
Cited by
118
References
109
Citations by year
2026: 7 · 2025: 17 · 2024: 14 · 2023: 13 · 2022: 19 · 2021: 18 · 2020: 8 · 2019: 10 · 2018: 11 · 2017: 1
FWCI
1.18
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Evidence-Based Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
  • Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
cigarette smoking, hepatocellular carcinoma, cancer incidence, cancer mortality, smoking as risk factor, former smokers, heavy smokers, smoking cessation
MeSH terms
Cigarette Smoking, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Risk Factors, Incidence, Evidence-Based Medicine

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