Contraceptive Steroids As A Risk Factor for Hepatocellular Carcinoma: A Case/Control Study in South African Black Women

Kew, Michael C.; Song, E; Mohammed, Abdullah Ali; Hodkinson, John

doi:10.1002/hep.1840110221

Cited by 41 publications

(28 citation statements)

References 12 publications

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“…In fact, 2 studies involving a larger number of cases that included women in regions endemic for HBV infection and HCC found a statistically nonsignificant decreased risk of HCC for use of oral contraceptives. 26,27 The effect of exogenous estrogen use on the reduction in HCC risk observed in this study is consistent with the Compared with never-users, P trend ϭ .0013 for ever-users with duration of use Յ12, Ͼ12 and Յ36, and Ͼ36 months. ¶Compared with never-users, P trend ϭ .0060 for ever-users with duration of use Յ12, Ͼ12 and Յ36, and Ͼ36 months.…”

Section: Discussionsupporting

confidence: 87%

“…Several case reports have described the occurrence of liver adenomas or focal nodular hyperplasia in women taking oral contraceptives, 20 and the possible association between use of oral contraceptives and the risk of HCC has been assessed in several studies. 3,17,[21][22][23][24][25][26][27] However, most of these studies were based on a very limited number of case subjects, and the results have been incon- …”

mentioning

confidence: 99%

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Role of Reproductive Factors in Hepatocellular Carcinoma: Impact on Hepatitis B- and C-Related Risk

Chang

et al. 2003

Hepatology

106

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Hepatocellular carcinoma (HCC) is more prevalent in men than in women. Estrogen may play some role in the development of HCC. We conducted a multicenter case-control study to evaluate the effects of reproductive factors on HCC risk, and to assess whether the association between each factor and HCC differs between hepatitis B surface antigen (HBsAg)-positive and -negative women, in which hepatitis C virus (HCV) is the major cause of HCC. The study included 218 women with HCC and 729 control women selected from nonbiological and firstdegree female relatives of patients with HCC. The risk of HCC was inversely related to the number of full-term pregnancies (FTP) (P trend ‫؍‬ .0216) and age at natural menopause (P trend ‫؍‬ .0251 among women aged 45-55 without prior surgical menopause). Oophorectomy at age <50 during premenopausal years was also a risk factor (multivariate-adjusted OR, 2.57; 95% CI, H epatocellular carcinoma (HCC) is a highly malignant disease characterized by a striking male predominance; the male-to-female ratios in the incidence of HCC range from 2 to 4 in geographically diverse populations. 1,2 This gender difference may be, at least in part, attributable to differences in exposure to lifestyle risk factors for HCC, such as alcohol consumption and cigarette smoking. 3,4 However, sex hormone and X-linked genetic factors may also be important.Estrogen receptors exist in both mammalian and human livers. [5][6][7][8] In experimental rats and mice, there is also a greater preponderance of HCC in male subjects compared with female subjects. This sex difference has been observed in various animal models, including transgenic mice expressing hepatitis B or C viral proteins. [9][10][11][12][13][14][15] In addition, ovariectomy in mice increased susceptibility to chemically induced hepatocarcinogenesis. 11,16 Although these observations may suggest some role for endogenous estrogen in the etiology of HCC in humans, these aspects received relatively scant attention. [17][18][19] Exogenous estrogen use may also be associated with the risk of HCC. Several case reports have described the occurrence of liver adenomas or focal nodular hyperplasia in women taking oral contraceptives, 20 and the possible association between use of oral contraceptives and the risk of HCC has been assessed in several studies. 3,17,[21][22][23][24][25][26][27] However, most of these studies were based on a very limited number of case subjects, and the results have been incon-

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 99%

Role of Reproductive Factors in Hepatocellular Carcinoma: Impact on Hepatitis B- and C-Related Risk

Chang

et al. 2003

Hepatology

106

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“…However, in populations with high prevalence of hepatitis virus infection, no significant relationship was found (WHO, 1989;Kew et al, 1990). A recent metaanalysis of 12 case-control studies indicated no association between short term OC use and risk of HCC, but the author did mention the possibility of a causal relationship in non-hepatitis B endemic areas with long-term OC use (Maheshwari et al, 2007).…”

Section: Oral Contraceptivesmentioning

confidence: 99%

Risk Factors of Hepatocellular Carcinoma - Current Status and Perspectives

Gao¹,

Xie²,

Yang³

et al. 2012

Asian Pacific Journal of Cancer Prevention

128

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“…Several studies, generally using small sample sizes, investigated a possible link between OC and HCC. The findings of these studies have been inconsistent and either included an increased risk of HCC [14,16,17,22] or no association [11][12][13]15,[18][19][20][21]. Therefore, we conducted this review and meta-analysis to critically examine the epidemiological evidence for the association between OC use and HCC risk.…”

Section: Introductionmentioning

confidence: 98%