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Diabetes Thought to Increase Risk for Hepatic Cancer

Nov 6, 2015

Diabetes Thought to Increase Risk for Hepatic Cancer

A retroactive study presented at the 2015 Annual Meeting for the American College of Gastroenterology (ACG) suggests that diabetes increases the risk for hepatocellular carcinoma. Hepatocellular carcinoma is the most common form of liver cancer. The disease generally occurs secondary to hepatitis C infection or in cirrhosis from other causes.

The study authors used data from MarketScan, which is a database for insurance claims of all kinds. They found 7,473 patients with hepatocellular carcinoma. The authors also included 22,110 controls matched for comorbidities, age, sex, and gender, leading to a 1-to-3 ratio of subjects to controls for 99% of the case subjects. The patients included in the case group had hepatocellular carcinoma with hepatitis C with DM, without DM, and DM alone. The study also looked at the impact of metabolic syndrome, hypertension, and dyslipidemia.

DM lead to a 1.47 increased risk for hepatocellular carcinoma development (95% CI, 1.363-1.589). Hypertension combined with DM led to an 3.399 increased risk; adding hepatitis C infection to that leads to a 4.58 increased risk of hepatocellular carcinoma. Hyperlipidemia with DM causes a 2.3 increased risk regardless of hepatitis C infection status.

This study only reports on an association. The authors did not posit an explanation for the increased risk that metabolic conditions pose for hepatocellular carcinoma. More research is needed to explore these tentative initial results before clinical recommendations about screening can be made.

Practice Pearls:

  • DM, with and without hepatitis C infection, leads to an increased risk of hepatocellular carcinoma.
  • The risk appears to be increased the most when patients have hepatitis C, hypertension, and DM simultaneously.
  • This retrospective study does not show causation, only correlation. The mechanism for how diabetes may increase the risk of hepatocellular carcinoma is unknown.

Kasmari A, Welch A, Liu G, et al. “Diabetes Mellitus and Metabolic Syndrome: Independent Risk Factors for Hepatocellular Carcinoma.” American College of Gastroenterology 2015 Annual Meeting. Presented 19 October 2015.