Risk factors for hepatocellular carcinoma (HCC) in the northeast of the United States: results of a case–control study

Yi Shen, Harvey Risch, Lingeng Lu, Xiaomei Ma, Melinda L. Irwin, Joseph K. Lim, Tamar Taddei, Karen Pawlish, Antoinette Stroup, Robert Brown, Zhanwei Wang, Wei JIA, Linda Wong, Susan T. Mayne, Herbert Yu*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review

29 Citations (Scopus)


Purpose: HCC incidence has been continuously rising in the US for the past 30 years. To understand the increase in HCC risk, we conducted a case–control study in Connecticut, New Jersey and part of New York City. Methods: Through rapid case ascertainment and random digit dialing, we recruited 673 incident HCC patients and 1,166 controls. Information on demographic and anthropometric characteristics, lifestyle factors, medical and family cancer histories, were ascertained through telephone interviews using a structured questionnaire. Saliva specimens were collected for testing hepatitis C virus (HCV) antibodies. Unconditional logistic regression models were utilized to calculate odds ratio (OR) and 95% confidence interval (CI) to determine HCC associations with risk factors. Results: The study confirmed that HCV infection and obesity were important risk factors for HCC, ORs 110 (95% CI 59.2–204) and 2.13 (95% CI 1.52–3.00), respectively. High BMI and HCV infection had synergy in association with elevated HCC risk. Patients both obese and infected with HCV had HCC detected on average nearly 10 years earlier than those with neither factor. Diabetes, cigarette smoking and heavy alcohol intake were all associated with increased risk of HCC, whereas aspirin and other NSAID use were associated with reduced risk. HCC cases tended to attain less education, with lower household incomes, unmarried, and to have had more sexual partners than the controls. Conclusions: Individuals at risk of HCC in the US comprise a unique population with low socioeconomic status and unhealthy lifestyle choices. Given the multifactorial nature, a comprehensive approach is needed in HCC prevention.

Original languageEnglish
Pages (from-to)321-332
Number of pages12
JournalCancer Causes and Control
Issue number4
Publication statusPublished - 1 Apr 2020

Scopus Subject Areas

  • Oncology
  • Cancer Research

User-Defined Keywords

  • HCC
  • HCV
  • Obesity
  • Risk factors


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