OBJECTIVE: Obesity and diabetes are associated with an increased liver cancer risk. However, most studies have examined all primary liver cancers or hepatocellular carcinoma, with few studies evaluating intrahepatic cholangiocarcinoma (ICC), the second most common type of liver cancer. Thus, we examined the association between obesity and diabetes and ICC risk in a pooled analysis and conducted a systematic review/meta-analysis of the literature. DESIGN: For the pooled analysis, we utilized the Liver Cancer Pooling Project, a consortium of 13 US-based, prospective cohort studies with data from 1,541,143 individuals (ICC cases n = 414). In our systematic review, we identified 14 additional studies. We then conducted a meta-analysis, combining the results from LCPP with results from the 5 prospective studies identified through September 2017. RESULTS: In the LCPP, obesity and diabetes were associated with a 62% [Hazard Ratio (HR) = 1.62, 95% Confidence Interval (CI): 1.24-2.12] and an 81% (HR = 1.81, 95% CI: 1.33-2.46) increased ICC risk, respectively. In the meta-analysis of prospectively ascertained cohorts and nested case-control studies, obesity was associated with a 49% increased ICC risk [Relative Risk (RR) = 1.49, 95% CI: 1.32-1.70; n = 4 studies; I2 = 0%]. Diabetes was associated with a 53% increased ICC risk (RR = 1.53, 95% CI: 1.31-1.78; n = 6 studies). While we noted heterogeneity between studies (I2 = 67%) for diabetes, results were consistent in subgroup analyses. Results from hospital-based case-control studies (n = 9) were mostly consistent, but these studies are potentially subject to reverse causation. CONCLUSIONS: These findings suggest that obesity and diabetes are associated with increased ICC risk, highlighting similar etiologies of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. However, additional prospective studies are needed to verify these associations.
OBJECTIVE:Obesity and diabetes are associated with an increased liver cancer risk. However, most studies have examined all primary liver cancers or hepatocellular carcinoma, with few studies evaluating intrahepatic cholangiocarcinoma (ICC), the second most common type of liver cancer. Thus, we examined the association between obesity and diabetes and ICC risk in a pooled analysis and conducted a systematic review/meta-analysis of the literature. DESIGN: For the pooled analysis, we utilized the Liver Cancer Pooling Project, a consortium of 13 US-based, prospective cohort studies with data from 1,541,143 individuals (ICC cases n = 414). In our systematic review, we identified 14 additional studies. We then conducted a meta-analysis, combining the results from LCPP with results from the 5 prospective studies identified through September 2017. RESULTS: In the LCPP, obesity and diabetes were associated with a 62% [Hazard Ratio (HR) = 1.62, 95% Confidence Interval (CI): 1.24-2.12] and an 81% (HR = 1.81, 95% CI: 1.33-2.46) increased ICC risk, respectively. In the meta-analysis of prospectively ascertained cohorts and nested case-control studies, obesity was associated with a 49% increased ICC risk [Relative Risk (RR) = 1.49, 95% CI: 1.32-1.70; n = 4 studies; I2 = 0%]. Diabetes was associated with a 53% increased ICC risk (RR = 1.53, 95% CI: 1.31-1.78; n = 6 studies). While we noted heterogeneity between studies (I2 = 67%) for diabetes, results were consistent in subgroup analyses. Results from hospital-based case-control studies (n = 9) were mostly consistent, but these studies are potentially subject to reverse causation. CONCLUSIONS: These findings suggest that obesity and diabetes are associated with increased ICC risk, highlighting similar etiologies of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. However, additional prospective studies are needed to verify these associations.
Authors: Tania M Welzel; Barry I Graubard; Hashem B El-Serag; Yasser H Shaib; Ann W Hsing; Jessica A Davila; Katherine A McGlynn Journal: Clin Gastroenterol Hepatol Date: 2007-08-06 Impact factor: 11.382
Authors: Jessica L Petrick; Baiyu Yang; Sean F Altekruse; Alison L Van Dyke; Jill Koshiol; Barry I Graubard; Katherine A McGlynn Journal: PLoS One Date: 2017-10-19 Impact factor: 3.240
Authors: Sarah S Jackson; Alison L Van Dyke; Bin Zhu; Ruth M Pfeiffer; Jessica L Petrick; Hans-Olov Adami; Demetrius Albanes; Gabriella Andreotti; Laura E Beane Freeman; Amy Berrington de González; Julie E Buring; Andrew T Chan; Yu Chen; Gary E Fraser; Neal D Freedman; Yu-Tang Gao; Susan M Gapstur; J Michael Gaziano; Graham G Giles; Eric J Grant; Francine Grodstein; Patricia Hartge; Mazda Jenab; Cari M Kitahara; Synnove F Knutsen; Woon-Puay Koh; Susanna C Larsson; I-Min Lee; Linda M Liao; Juhua Luo; Emma E McGee; Roger L Milne; Kristine R Monroe; Marian L Neuhouser; Katie M O'Brien; Ulrike Peters; Jenny N Poynter; Mark P Purdue; Kim Robien; Dale P Sandler; Norie Sawada; Catherine Schairer; Howard D Sesso; Tracey G Simon; Rashmi Sinha; Rachael Z Stolzenberg-Solomon; Shoichiro Tsugane; Renwei Wang; Elisabete Weiderpass; Stephanie J Weinstein; Emily White; Alicja Wolk; Jian-Min Yuan; Anne Zeleniuch-Jacquotte; Xuehong Zhang; Katherine A McGlynn; Peter T Campbell; Jill Koshiol Journal: Cancer Res Date: 2019-05-21 Impact factor: 12.701
Authors: Sarah S Jackson; Hans-Olov Adami; Gabriella Andreotti; Laura E Beane-Freeman; Amy Berrington de González; Julie E Buring; Gary E Fraser; Neal D Freedman; Susan M Gapstur; Gretchen Gierach; Graham G Giles; Francine Grodstein; Patricia Hartge; Mazda Jenab; Victoria Kirsh; Synnove F Knutsen; Qing Lan; Susanna C Larsson; I-Min Lee; Mei-Hsuan Lee; Linda M Liao; Roger L Milne; Kristine R Monroe; Marian L Neuhouser; Katie M O'Brien; Jessica L Petrick; Mark P Purdue; Thomas E Rohan; Sven Sandin; Dale P Sandler; Norie Sawada; Aladdin H Shadyab; Tracey G Simon; Rashmi Sinha; Rachael Stolzenberg-Solomon; Shoichiro Tsugane; Elisabete Weiderpass; Alicja Wolk; Hwai-I Yang; Wei Zheng; Katherine A McGlynn; Peter T Campbell; Jill Koshiol Journal: J Hepatol Date: 2020-05-11 Impact factor: 25.083
Authors: Andrea A Florio; Peter T Campbell; Xuehong Zhang; Anne Zeleniuch-Jacquotte; Jean Wactawski-Wende; Stephanie A Smith-Warner; Rashmi Sinha; Tracey G Simon; Howard D Sesso; Catherine Schairer; Lynn Rosenberg; Thomas E Rohan; Kim Robien; Andrew G Renehan; Mark P Purdue; Jenny N Poynter; Julie R Palmer; Christina C Newton; Yunxia Lu; Martha S Linet; Linda M Liao; I-Min Lee; Jill Koshiol; Cari M Kitahara; Victoria A Kirsh; Jonathan N Hofmann; Barry I Graubard; Edward Giovannucci; John M Gaziano; Susan M Gapstur; Neal D Freedman; Jane Demuth; Dawn Q Chong; Andrew T Chan; Julie E Buring; Patrick T Bradshaw; Laura E Beane Freeman; Katherine A McGlynn; Jessica L Petrick Journal: Int J Cancer Date: 2019-12-23 Impact factor: 7.316