Diabetes Triples Risk of Liver Cancer

Diabetic patients run three times the risk of developing liver cancer, suggests a large US study in Gut.

The researchers trawled a surveillance database used for patients in receipt of Medicare funding for health care, to identify patients aged 65 and older, who had been diagnosed with liver cancer.

They found 2061 patients with liver cancer on records spanning the five years between 1994 and 1999. They also randomly selected more than 6,000 other similarly aged patients from the database, who had not been diagnosed with cancer.

They checked the claims records for known risk factors for liver cancer, including hepatitis C and B viral infections, alcoholic liver disease, and haemochromatosis (poor absorption and storage of iron). They also checked the claims records for diabetes.

Compared with patients who did not have the disease, those with liver cancer were around twice as likely to be male and of non-white ethnicity. And the proportion of patients with diabetes was almost twice as high among those with liver cancer.

After taking into account, demographics and other major risk factors, diabetes almost tripled the risk of liver cancer. But the findings also suggest that hepatitis C could also interact with diabetes to further boost the risk of developing liver cancer.

The authors suggest that diabetes might be an independent risk factor for liver cancer, rates of which have increased significantly in the US in recent years.

[Diabetes increases the risk of hepatocelluar carcinoma in the United States: a population based case control study Gut 2005; 54: 533-9]

Click here to view the paper in full:

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FACT:
Extremely low adherence to the ADA standard of care guideline regarding routine low-dose aspirin prophylaxis in adults with DM and at least one CV risk factor. They found: “During 1997 – 2000, more than one third of all diabetic patients should have been considered for ASA prophylaxis because they had one or more CV risk factors. Yet, from 1997 to 2000, the percentage of these patients given ASA for primary prevention was 2.8% in 1997, 2.9% in 1998, 2.1% in 1999, and 5.7% in 2000. Factors associated with increased ASA prophylaxis were non-white ethnicity, male gender, older age (more than 44 years old), rural clinic setting, preventative counseling given during visit, being prescribed more than two medications, having cardiovascular risk factors, and being seen by a cardiologist.” The researchers concluded: “Adherence rates to the ADA standard of care guideline regarding routine ASA prophylaxis in adults with DM and at least one CV risk factor are extremely low. National efforts directed at increasing these rates of ASA prophylaxis are indicated to meet the Healthy People 2010 goal of 30%.”
Fam Med 2005;37(2):112-7. February 2005 For the full article, click here.

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