Body Mass Index, Diabetes and Intrahepatic Cholangiocarcinoma Risk: The Liver Cancer Pooling Project and Meta-analysis
Year: 2018
Type: article
Study design: Systematic Review
Abstract: 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 casesn= 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: Jessica L. Petrick, Jake E. Thistle, Anne Zeleniuch-Jacquotte, Xuehong Zhang, Jean Wactawski-Wende, Alison L. Van Dyke, Meir J. Stampfer, Rashmi Sinha, Howard D. Sesso, Catherine Schairer, Lynn Rosenberg, Thomas E. Rohan, Kim Robien, Mark P. Purdue, Jenny N. Poynter, Julie R. Palmer, Christina C. Newton, Martha S. Linet, Linda M. Liao, I-Min Lee, Jill Koshiol, Cari M. Kitahara, Jonathan N. Hofmann, Barry I. Graubard, Edward Giovannucci, Michael J. Gaziano, Susan M. Gapstur, Neal D. Freedman, Dawn Q. Chong, Andrew T. Chan, Julie E. Buring, Laura Beane E. Freeman, Peter T. Campbell, Katherine A. McGlynn
Institutions: Boston University, Brigham and Women's Hospital, Albert Einstein College of Medicine, Harvard University, George Washington University, National Cancer Institute, Division of Cancer Epidemiology and Genetics, New York University, University at Buffalo, State University of New York, University of Minnesota, Masonic Cancer Center, American Cancer Society, VA Boston Healthcare System, National Cancer Centre Singapore, Massachusetts General Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Studies of Rare Cancers, G1160275816, G1851278524, G2214254730, G229684361, G231467711, G3062349281, G3426488059, G3643850837, Dietary and Hormonal Determinants of Cancer in Women, G4592503987, The Women's Health Study: Addition of New Data to Maximize its Research Impact, Mentored Patient-Oriented Research in Digestive Diseases, G7332203415, A Follow-up Study for Causes of Cancer in Black Women, Women's Health Study: Continued Follow-up, Cancer Epidemiology Cohort in Male Health Professionals, G8606882599, Center for the Study of Inflammatory Bowel Disease at Massachusetts General Hospital
OpenAlex ID: W2889067852