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

Abstract

Both alcohol abuse and liver cirrhosis are known risk factors for various cancers. We aimed to assess the long-term risk of malignancies among patients with severe alcoholic liver disease, i.e., alcoholic liver cirrhosis and alcoholic hepatitis. A cohort of 8796 male and 3077 female alcoholic liver disease patients from 1996-2013 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 to the number of cancers in the general population. The number of malignancies in our cohort was 1052 versus 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 37.1; 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), esophagus (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 alcoholic liver disease patients. Severe alcoholic liver disease 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. This article is protected by copyright. All rights reserved.

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