Cancer incidence among alcoholic liver disease patients in Finland: A retrospective registry study during years 1996–2013

• Published in: International journal of cancer 2016-06, Vol.138 (11), p.2616-2621
• Main Authors: Sahlman, Perttu, Nissinen, Markku, Pukkala, Eero, Färkkilä, Martti
• Format: Article
• Language: English
• Subjects: Adult; Aged; alcoholic hepatitis; alcoholic liver disease; Cancer; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - pathology; Female; Finland - epidemiology; Hepatitis; hepatocellular carcinoma; Humans; Kidneys; Liver cancer; Liver cirrhosis; Liver diseases; Liver Diseases, Alcoholic - complications; Liver Diseases, Alcoholic - epidemiology; Liver Diseases, Alcoholic - pathology; Liver Neoplasms - complications; Liver Neoplasms - epidemiology; Liver Neoplasms - pathology; Male; Medical research; Middle Aged; Pancreas; Registries; Retrospective Studies; Risk Factors; Surveillance
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.29995

Both alcohol abuse and liver cirrhosis are known risk factors for various cancers. This article was aimed to assess the long‐term risk of malignancies among patients with severe alcoholic liver disease (ALD), i.e., alcoholic liver cirrhosis and alcoholic hepatitis. A cohort of 8,796 male and 3,077 female ALD patients from 1996 to 2012 was identified from the Finnish National Hospital Discharge Register. This nationwide cohort was combined with the data from the Finnish Cancer Registry for incidence of malignancies during the years 1996–2013. The cancer cases diagnosed were compared with the number of cancers in the general population. The number of malignancies in our cohort was 1,052 vs. 368 expected. There was statistically significant excess of cancers of the liver, (standardized incidence ratio [SIR] 59.20; 95% CI 53.11–65.61), pancreas (SIR 3.71; 95% CI 2.72–4.94), pharynx (SIR 9.25; 95% CI 6.05–13.56), mouth (SIR 8.31; 95% CI 4.84–13,29), oesophagus (SIR 7.92; 95% CI 5.49–11.07), tongue (SIR 7,21; 95% CI 3.60–12.89), larynx (SIR 5.20; 95% CI 2.77–8.89), lung (SIR 2.77; 95% CI 2.27–3.32), stomach (SIR 2.76; 95% CI 1.79–4.07), kidney (SIR 2.69; 95% CI 1.84–3.79) and colon (SIR 2.33; 95% CI 1.70–3.11). There was no decreased risk of any cancer among ALD patients. Severe ALD is associated with markedly increased risk of malignancies. The risk is especially high for hepatocellular carcinoma, but also significantly increased for cancers of the upper aerodigestive tract, pancreas and kidneys, and warrants cancer surveillance in selected cases. What's New? Alcoholic liver disease (ALD) patients have an increased risk of several cancers. Here the authors assessed the long‐term risk of malignancies in patients with ALD in Finland. They found that the risk is particularly high for hepatocellular carcinoma in both patients with alcoholic hepatitis and alcoholic liver cirrhosis but is also significantly increased for cancers of the upper aerodigestive tract, pancreas and kidneys. As none of the cancer risks is lower among ALD patients compared with the general population, special cancer surveillance could be required in patients with severe ALD.