Systematic review: the association between obesity and hepatocellular carcinoma – epidemiologic evidence

David Anthony Saunders (1) , David Seidel (2) , Michael Allison (3) , Georgios Lyratzopoulos (2)

1 School of Clinical Medicine
2 Department of Public Health and Primary Care
3 Department of Medicine

Background: Evidence increasingly implicates obesity as an independent risk factor for different cancers. We examined such evidence for hepatocellular carcinoma. Aim: To review the effect of increased levels of body mass index on hepatocellular carcinoma risk. Methods: We systematically reviewed the literature examining the association between increasing body mass index and hepatocellular carcinoma risk. For each identified study, relevant data were extracted and appraised. Results: Ten cohort studies (>90 million person-years), one nested case-control study (244 cases) and two case-control studies (494 cases) were identified. Of the cohort studies, 75% of person-years related to North Americans, 15% to East Asians, and 10% to Europeans. Three cohort studies adjusted for alcohol consumption, only one cohort study adjusted for hepatitis infection status. Seven cohort studies found a positive association between obesity (body mass index ≥30 kg/m2) and hepatocellular carcinoma risk (relative risks ranging from 1.4-4.1); two reported no association; and one reported a significant inverse association for a population subgroup (relative risk = 0.7, 95% confidence interval: 0.5-0.9). Conclusion: Although most studies did not adjust for confounders and most data relate to a single world region, the overall evidence is suggestive of an increased hepatocellular carcinoma risk in obese and overweight individuals.

Mots clés: Medicine

David Anthony Saunders, David Seidel, Michael Allison, Georgios Lyratzopoulos. Systematic review: the association between obesity and hepatocellular carcinoma – epidemiologic evidence. Alimentary Pharmacology and Therapeutics, 2010, ⟨10.1111/j.1365-2036.2010.04271.x⟩. ⟨hal-00552532⟩