Diabetes may increase risk of liver cancer

Diabetes appears to be an independent risk factor for hepatocelluration carcinoma, with the risk of rising as duration of the endocrine disease increases, according to an ongoing, prospective case-control study.

Also, the magnitude of risk for HCC seems to vary with the type of diabetes treatment used, reported at the annual meeting of the American Association for Cancer Research.

The department of gastrointestinal medical oncology at M.D. Anderson Cancer Center, Houston, presented results from a prospective study involving 420 patients with HCC and 1,109 controls who did not have cancer. The prevalence of diabetes was 23.3% among the cancer patients and 10.4% in controls.

After adjustments for HCC risk factors such as heavy alcohol use, smoking, and hepatitis C infection, and for demographic variables, the odds of developing HCC were increased threefold in patients with a 2 to 5-year history of diagnosed diabetes, 4-8 fold those with a 6 to 10 years diabetes duration, and 6.6 fold for those with more than a 10 years disease duration, compared with nondiabetics.

Subjects on oral agents had an adjusted 3.6 folds greater risk of HCC than did nondiabetics. The risk was increased 6.2 folds in insulin treatment patients, 8.7 folds in those on insulin and oral agents, and 28 folds in those managed by diet only.

Among diabetic patients on oral agents, the HCC risk was 20.5 fold greater in those on solfonylurea drugs than in nondiabetics. In contrast, biguanide therapy was associated with a 2.5 folds increased risk, and thiazolidinedoines had a modest 1.3 fold risk.