Hepatocellular carcinoma in Great Britain: Influence of age, sex, HBsAg status, and aetiology of underlying cirrhosis

Abstract

An analysis of 294 patients who died with cirrhosis showed that 24% had developed hepatocellular carcinoma. Hemochromatosis and HBsAg positive chronic active hepatitis were high risk groups (36% and 42%, respectively) and the frequency was lowest in primary biliary cirrhosis and HBsAg negative chronic active hepatitis (3% and 11%, respectively). Those with hepatocellular carcinoma showed a striking male preponderance (11:1) and further analysis has shown that the proportion developing this tumor in each group was closely related to the proportion of males in that group (r = 0.97). Age was the only other significant factor, malignant change occurring more commonly in those over the age of 50 yr than those below (30% and 7%, respectively, P < 0.005). The influence of HBsAg was largely accounted for by the know predisposition of males to carry HBsAg. The group of patients who had developed this tumor without cirrhosis were younger (mean age 39 yr) and had a lower male to female ratio of 1.1:1 and the place of contraceptive-related tumor within this group is discussed.