Alcoholism and liver cirrhosis in the etiology of primary liver cancer

Int J Cancer. 1992 Jul 30;51(6):898-902. doi: 10.1002/ijc.2910510611.


The aim of this study was to determine the risk of developing primary liver cancer in patients with a diagnosis of alcoholism, liver cirrhosis, or both. Three population-based, mutually exclusive cohorts were defined on the basis of hospital discharge diagnosis between 1965 and 1983. Complete follow-up through 1984--excluding the first year of follow-up--showed that among 8,517 patients with a diagnosis of alcoholism, 13 cancers occurred, vs. 4.2 expected (standardized incidence ratio (SIR) = 3.1; 95% confidence interval (CI) = 1.6 to 5.3); among 3,589 patients with liver cirrhosis, 59 cancers occurred, vs. 1.7 expected (SIR = 35.1; 95% CI = 26.7 to 45.3), and among 836 patients with both diagnoses, 11 cancers occurred, vs. 0.3 expected (SIR = 34.3; 95% CI = 17.1 to 61.3). Thus, alcoholism alone entailed a moderately increased risk and alcoholism with liver cirrhosis did not increase the high relative risk for liver cancer more than cirrhosis alone. We conclude that alcohol intake may be a liver carcinogen only by being causally involved in the development of cirrhosis; and further, that the risk of developing liver cancer following cirrhosis in this population is similar to or higher than that after chronic hepatitis-B-virus infection in other Western countries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Alcoholism / complications*
  • Alcoholism / epidemiology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis, Alcoholic / complications*
  • Liver Cirrhosis, Alcoholic / epidemiology
  • Liver Neoplasms / epidemiology
  • Liver Neoplasms / etiology*
  • Male
  • Middle Aged
  • Registries
  • Sweden / epidemiology