Risk Factors for the Rising Rates of Primary Liver Cancer in the United States

Abstract

RECENTLY, WE reported a statistically significant increase in the number of cases of hepatocellular carcinoma diagnosed in the United States over the past 2 decades.¹ Information about the incidence, hospitalization, and mortality in cases of hepatocellular carcinoma were obtained from 3 data sources: the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, the Department of Veteran Affairs (VA) Patient Treatment File (PTF), and the US vital statistics, respectively.¹ However, the cause(s) of this rise in the number of cases of hepatocellular carcinoma remains unknown. Of the 3 databases used, only the VA PTF contains information about the main risk factors and medical conditions associated with hepatocellular carcinoma, such as alcoholic cirrhosis or viral hepatitis. In the present study, information from the main files of the VA PTF were used to examine the temporal trends of risk factors among patients diagnosed as having primary liver cancer between 1993 and 1998.