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

https://arctichealth.org/en/permalink/ahliterature274985
Source
Int J Cancer. 2016 Jun 1;138(11):2616-21
Publication Type
Article
Date
Jun-1-2016
Author
Perttu Sahlman
Markku Nissinen
Eero Pukkala
Martti Färkkilä
Source
Int J Cancer. 2016 Jun 1;138(11):2616-21
Date
Jun-1-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Carcinoma, Hepatocellular - complications - epidemiology - pathology
Female
Finland - epidemiology
Humans
Liver Diseases, Alcoholic - complications - epidemiology - pathology
Liver Neoplasms - complications - epidemiology - pathology
Male
Middle Aged
Registries
Retrospective Studies
Risk factors
Abstract
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.
PubMed ID
26756434 View in PubMed
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Incidence, survival and cause-specific mortality in alcoholic liver disease: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature282147
Source
Scand J Gastroenterol. 2016 Aug;51(8):961-6
Publication Type
Article
Date
Aug-2016
Author
Perttu Sahlman
Markku Nissinen
Eero Pukkala
Martti Färkkilä
Source
Scand J Gastroenterol. 2016 Aug;51(8):961-6
Date
Aug-2016
Language
English
Publication Type
Article
Keywords
Cause of Death
Cohort Studies
Female
Finland - epidemiology
Hepatitis, Alcoholic - epidemiology - mortality
Humans
Liver Cirrhosis, Alcoholic - epidemiology - mortality
Liver Diseases, Alcoholic - epidemiology - mortality
Male
Abstract
We studied the incidence of severe ALD requiring hospitalization in Finland, and survival and causes of death among the ALD patients.
A cohort of 11,873 persons (8796 men and 3077 women) with diagnosis of ALD during the years 1996-2012 was identified from Finnish national Inpatient Register. The annual incidence of alcoholic hepatitis (AH) and alcoholic liver cirrhosis was calculated. The cohort was combined with the data from national Cause of Death Register of Statistics Finland.
The incidence of alcoholic liver cirrhosis increased from 8.8/100,000 in year 2001 to 14.6/100,000 in year 2012 among men and from 2.4 to 4.2/100,000 among women. The incidence of AH increased from 3.7 to 6.5/100,000 among men and from 1.3 to 2.7/100,000 among women. The relative 5-year survival ratios of patients with alcoholic liver cirrhosis and AH were 29 and 50% among men and 38 and 52% among women, respectively. Out of 8440 deaths, 65% were due to alcoholic-related causes. The risk of death among ALD patients was increased in malignancies (SMR 6.82; 95% CI: 6.35-7.29), cardiovascular diseases (6.13; 5.74-6.52), respiratory diseases (7.86; 6.70-9.10), dementia (3.31; 2.41-4.44) and accidents and violence (11.12; 10.13-12.15).
The incidence of AH and alcoholic liver cirrhosis is increasing. The survival is poor. Most deaths are alcohol-related and other common causes of excess deaths are cancers especially in the upper aerodigestive tract and cardiovascular, digestive and respiratory diseases as well as violence and accidents.
PubMed ID
27181618 View in PubMed
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