The association between diabetes and hepatocellular carcinoma: a systematic review of epidemiologic evidence.

By H. B. EL‐SERAG, H. Hampel, F. Javadi. Clinical Gastroenterology and Hepatology, 2006

829 citations recorded by the source corpus.

BACKGROUND & AIMS We conducted a systematic review and a meta-analysis to estimate the magnitude and determinants of association between diabetes and hepatocellular carcinoma (HCC). METHODS MEDLINE searches were conducted for published full studies (between January 1966 and February 2005) that provided risk estimates and met criteria concerning the definition of exposure and outcomes. Two investigators independently performed standardized search and data abstraction. Unadjusted and adjusted odds ratios for individual outcomes were obtained or calculated for each study and were synthesized using a random-effects model. RESULTS A total of 26 studies met our inclusion and exclusion criteria. Among 13 case-control studies, diabetes was associated significantly with HCC in 9 studies (pooled odds ratio, 2.5; 95% confidence interval, 1.8-3.5). Among 13 cohort studies, diabetes was associated significantly with HCC in 7 studies (pooled risk ratio, 2.5; 95% confidence interval, 1.9-3.2). The results were relatively consistent in different populations, different geographic locations, and a variety of control groups. The significant association between HCC and diabetes was independent of alcohol use or viral hepatitis in the 10 studies that examined these factors. Few studies adjusted for diet and obesity. CONCLUSIONS Diabetes is associated with an increased risk for HCC. However, more research is required to examine issues related to the duration and treatment of diabetes, and confounding by diet and obesity.

Subfields: Epidemiology, Molecular Biology, Oncology

View Paper: https://www.semanticscholar.org/paper/69d28968882a0aa51db6afb4a90af0cfc8b1a643

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Epidemiology

1. H. B. EL‐SERAG
2. R. Lopez
3. C. Day
4. S. Bellentani
5. V. Ratziu
6. N. Zein
7. T. Tamimi
8. Ariel F. Feldstein

In Molecular Biology

1. H. B. EL‐SERAG

In Oncology

1. H. B. EL‐SERAG
2. S. Larsson
3. A. Wolk
4. M. Woodward
5. R. Huxley
6. Ali G. Moghaddam

Citations in the corpus

• iArc monogrAphs on the evAluAtion oF cArcinogenic risks to humAns (2012, background): “A meta-analysis of 26 studies (13 case– control studies and 13 cohort studies) published through February 2005 indicated that diabetes mellitus appears to be an independent risk factor for HCC (El-Serag et al., 2006).”
• Hepatocellular carcinoma in non-alcoholic fatty liver disease: an emerging menace. (2012, background): “Substantial evidence indicates that diabetes promotes the development and progression of HCC [11].”
• A position statement on NAFLD/NASH based on the EASL 2009 special conference. (2010, background): “Causes of death are liver failure, sepsis and variceal hemorrhage, or hepatocellular carcinoma (HCC) [60,61].”
• Long-term All-Cause Mortality in Cancer Patients With Preexisting Diabetes Mellitus (2008, neutral): “Hepatocellular 3 (5)30,37,44 3724 848b 1.”
• Epidemiology of Hepatocellular Carcinoma in the United States: Where Are We? Where Do We Go? (2014, background): “5 for the association between diabetes and HCC independent of viral hepatitis or alcohol use.(29,30) Cirrhosis causes glucose intolerance and type 2 diabetes, and also leads to HCC, making it difficult to interpret the association between HCC and diabetes, especially in case-control and cross-sectio”
• Diabetes mellitus and risk of breast cancer: A meta‐analysis (2007, background): “5-fold increased risk of hepatocellular carcinoma.(9) Wolf et al.”
• The incidence and risk factors of hepatocellular carcinoma in patients with nonalcoholic steatohepatitis (2010, background): “Several studies have examined the association between diabetes and HCC with conflicting results.(27,29) In fact, these studies failed to identify whether diabetes precedes the development of underlying liver disease or HCC.”
• Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors. (2008, background): “5fold increased risk for HCC, when taking account of the major risk factors for the disease [141].”