Incidence of cancer in primary biliary cirrhosis: The Mayo experience

Patients with primary biliary cirrhosis (PBC) may be at increased risk for malignancies. Several studies have addressed the risk of specific malignanc ies; however, there is little information about overall incidences of malig nancies in these patients. We hypothesize that these patients may be at an increased risk for cancer. We performed a retrospective chart review evalua ting patients with the diagnosis of PBC and malignancies. We reviewed recor ds of patients with PBC presenting to the Mayo Clinic between 1976 and 1985 . The diagnosis of PBC was made using evidence of cholestasis, positive ant imitochondrial antibody titers and liver biopsy findings consistent with PB C, The incidence of malignancies were then compared with published data by the Surveillance, Epidemiology and End Results (SEER) program of the Nation al Cancer Institute. Of the 1,692 patients with PBC in the Mayo Clinic data base, 114 patients were identified with primary cancer,The number of malig nancies was higher than would be anticipated by chance alone; with 93 obser ved versus 62.4 expected events (P < .001), Hepatobiliary malignancies had a relative risk of 46 (P < .0001) for women and SS (P < .0001) in men, Ther e was a dramatic increased risk for development of hepatobiliary malignanci es. PBC patients might benefit from more aggressive surveillance for hepato biliary malignancies during their lifetime.