AFRICAN IRON OVERLOAD AND HEPATOCELLULAR-CARCINOMA (HA-7-0-080)

Although HLA-linked hemochromatosis greatly increases the risk for hep atocellular carcinoma in people of European ancestry, iron overload in Africa is not thought to be etiologically related to this malignancy, To determine if African iron overload may be associated with hepatoce llular carcinoma, we reviewed 320 consecutive diagnostic liver biopsie s processed at the University of Zimbabwe from 1992 to 1994 and we sel ected for analysis 215 biopsies from adults that were suitable for the histological assessment of hepatocellular iron. Subjects were stratif ied according to hepatocellular iron grades of 0-2+ (normal levels to mild siderosis; n=183) and grades of 3+ and 4+ (distinctly elevated le vels consistent with iron overload; n=32). Thirty-six subjects had hep atocellular carcinoma. Logistic regression modeling revealed a signifi cant association between iron overload and hepatocellular carcinoma af ter adjustment for age, sex and and the presence of portal fibrosis or cirrhosis (p=0.041). The odds of hepatocellular carcinoma in subjects with iron overload was 3.1 (95% confidence interval of 1.05-9.4) time s that of subjects without iron overload, While we could not test for exposure to viral hepatitis or to aflatoxins in this study, our findin gs suggest that iron overload may be a risk factor for hepatocellular carcinoma in Africa.