Diabetes increases the risk
of hepatocellular carcinoma
Diabetes increases the risk of hepatocellular carcinoma
Diabetes is associated with a two-to-three-fold increase in the risk of liver cancer
(hepatocellular carcinoma; HCC), regardless of the presence of other major risk
factors -Hashem El-Serag, Houston Veteran Affairs Medical Center, Texas.

Dr. El-Serag and his group used the Surveillance Epidemiology and End-Results
Program (SEER)-Medicare linked database to identify patients aged 65 years and
older diagnosed with HCC and randomly selected non-cancer controls between 1994
and 1999. They searched inpatient and outpatient claims files for diagnostic codes
indicative of diabetes, hepatitis C virus (HCV), hepatitis B virus (HBV), alcoholic liver
disease, and haemochromatosis. In multiple logistic regression analyses, they found
that diabetes was associated with a threefold increase in the risk of HCC. In a subset
of patients without major risk factors, the adjusted odds ratio for diabetes declined but
remained significant (diabetics have higher odds of getting the disease). In addition,
they detected a significant positive interaction between HCV and diabetes. [Gut. 2005
Apr;54(4):533-9].

Case reports have shown progression of nonalcoholic fatty liver disease to cirrhosis
and hepatocellular carcinoma. And, both obesity and diabetes are frequently
associated with nonalcoholic fatty liver disease [Caldwell SH et al, Obesity and
hepatocellular carcinoma, Gastroenterology. 2004 Nov;127(5 Suppl 1):S97-103]
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