HEPATITIS-A AND HEPATITIS-C VIRUS, CLONORCHIS-SINENSIS FOR THE RISK OF LIVER-CANCER - A CASE-CONTROL STUDY IN PUSAN, KOREA

Background. Liver cancer mortality in Korea is the highest in the worl d. Hepatitis B and C viruses (HBV, HCV) are known to be the major risk factors of hepatocellular carcinoma (HCC). Cholangiocarcinoma (CLG) a ccounts for more than 20% of liver cancer in the Pusan area. In Korea, the different roles of known risk factors in the development of HCC o r CLG have not been adequately evaluated. Methods. Case-control studie s involved 203 incident HCC cases, 406 controls matched to the HCC cas es for age (+/- 4 years) and sex, and 41 CLG cases (the HCC controls w ere used). They were carried out from August 1990 to August 1993. Resu lts. Relative risk (RR) of HBsAg (87.4; 95% confidence interval [CI]:2 2.2-344.3) and RR of anti-HCV positivity (30.3; 95% CI : 6.1-150.6) we re significant for the risk of HCC after adjustment for potentially co nfounding factors. In contrast, RR of Clonorchis sinensis in stool (2. 7; 95% CI : 1.1-6.3) and RR of heavy drinking (4.6; 95% CI : 1.4-15.2) were significant for the risk of CLG. Transfusion history, acupunctur e history, and cigarette smoking were not associated with the risk of HCC or CLG. Conclusions. Strong evidence indicated that both HBV and H CV infection were independent risk factors for HCC. In contrast, C. si nensis in stools and heavy drinking were associated with the risk of C LG in Korea.