Epidemiology

Hereditary hemochromatosis boosts liver cancer risk

Last Updated: 2003-12-24 14:00:39 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - People with hereditary hemochromatosis, particularly men, are at significantly increased risk of liver cancer, Swedish researchers report. However, Dr. Maria Elmberg told Reuters Health, "Our study shows that although patients with hemochromatosis have a substantial risk of liver cancer, mild to moderate iron overload does not appear to cause cancer outside the liver."

Dr. Elmberg of the Karolinska Institute, Stockholm, and colleagues note in the December issue of Gastroenterology that some studies have linked hemochromatosis to a 200-fold increased risk of liver cancer and a heightened risk of non-hepatic malignancies.

To investigate further, the researchers conducted a population-based cohort study of 1847 Swedish patients with hereditary hemochromatosis and 5973 of their first-degree relatives.

Overall, there were 62 liver cancers and 128 that were not hepatobiliary. The hemochromatosis patients were at a 20-fold increased risk of liver cancer, Dr. Elmberg's group found. "The risk was 30-fold among men and 7-fold among women."

At 10 years of follow-up, the absolute risk of liver cancer was 6% in men and 1.5% in women. The risk of other cancers was almost unaltered (standardized incidence ratio 1.2).

Relatives also did not have an increased risk of extrahepatic cancer, but were at a modest increased risk of hepatobiliary cancer (standardized incidence ratio 1.5).

The researchers thus conclude that although the liver cancer risk is increased in patients with hereditary hemochromatosis, "the magnitude of risk is lower than previous estimates."

Gastroenterology 2003;125:1733-1741.