A study, carried out by investigators at Houston Veterans Affairs Medical Center, examined the association between diabetes and increased risk of hepatocellular carcinoma ( HCC ).

They used the Surveillance Epidemiology and End-Results Program (SEER)-Medicare database to identify patients aged 65 years and older diagnosed with hepatocellular carcinoma between 1994 and 1999.

The study included 2061 patients with liver cancer and 6183 non-cancer controls.

The 43% of HCC patients had diabetes three years prior to HCC diagnosis, compared to 19% of non-cancer controls .

After adjustment for other HCC risk factors ( infection by hepatitis C virus or hepatitis B virus, alcoholic liver disease, and haemochromatosis ), diabetes was associated with a threefold increase in the risk of hepatocellular carcinoma.

The odds ratio for diabetes, in a subset of patients without these major risk factors, remained significant ( OD= 2.87 ).

A significant positive interaction between hepatitis C virus and diabetes was detected ( p<0.0001 ). Similar findings persisted in analyses restricted to diabetes recorded between two and three years prior to HCC diagnosis.

Findings from this population based study suggest that diabetes is an independent risk factor for hepatocellular carcinoma.

Source: Gut, 2005

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