Hepatitis, alcohol consumption, cigarette smoking, and hepatocellular carcinoma in Los Angeles.

Seventy-eight black patients and white patients with primary hepatocellular carcinoma (PHC), 70 years or younger at diagnosis, and 78 age-, sex-, and race-matched neighborhood controls were interviewed. Information sought included usual dietary and drinking habits, cigarette smoking habits, prior medical conditions including a history of hepatitis, prior exposure to blood products, and occupational history. Cigarette smoking was a risk factor for PHC; the relative risk (RR) for current smokers of more than one pack/day compared to nonsmokers was 2.6. Alcohol consumption was also a significant risk factor for PHC; individuals who drank 80 g or more of ethanol per day had a RR of 4.2 compared to those drinking less than 10 g/day. In addition, a history of hepatitis (RR = 13.0) and a history of blood transfusions (RR = 7.0) were significant risk factors for PHC. Each of these factors remained significant after adjustment was made for the others.