Long-term incidence in hepatocellular carcinoma and intrahepatic bile duct cancer in Denmark, Finland, Norway and Sweden, role of Thorotrast?

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http://hdl.handle.net/10138/346121

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Hemminki , K , Tichanek , F , Försti , A , Hemminki , O , Liska , V & Hemminki , A 2022 , ' Long-term incidence in hepatocellular carcinoma and intrahepatic bile duct cancer in Denmark, Finland, Norway and Sweden, role of Thorotrast? ' , International Journal of Cancer , vol. 151 , no. 4 , pp. 510-517 . https://doi.org/10.1002/ijc.34031

Title: Long-term incidence in hepatocellular carcinoma and intrahepatic bile duct cancer in Denmark, Finland, Norway and Sweden, role of Thorotrast?
Author: Hemminki, Kari; Tichanek, Filip; Försti, Asta; Hemminki, Otto; Liska, Vaclav; Hemminki, Akseli
Contributor organization: Clinicum
Research Programs Unit
University of Helsinki
TRIMM - Translational Immunology Research Program
Urologian yksikkö
HUS Abdominal Center
Department of Oncology
HUS Comprehensive Cancer Center
Date: 2022-08-15
Language: eng
Number of pages: 8
Belongs to series: International Journal of Cancer
ISSN: 0020-7136
DOI: https://doi.org/10.1002/ijc.34031
URI: http://hdl.handle.net/10138/346121
Abstract: We analyzed long-term incidence trends in liver cancer (including hepatocellular carcinoma and intrahepatic cholangiocarcinoma) with an aim to interpret the changes in terms of known risk factors and hypothesize that historical exposure to Thorotrast, a radiographic contrast medium emitting alpha particles, has changed population rates. The NORDCAN database was used to collect cancer registry data from Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE), which we used from 1953 (DK, FI and NO) and 1960 (SE) through 2019. Thorotrast, which caused a 100-fold risk of liver cancer was used in DK and SE, and probably also in FI between 1930 and 1950, but not in NO. The incidence trend for liver cancer showed a broad maximum at around 1980, most prominent and statistically significant in SE and DK men and women, and in all countries, a steadily increasing trend towards the end of follow-up. Incidence for NO was lower than for the other countries and the rates showed no peaking at around 1980. Birth cohort analysis identified a transient risk which could be dated to a period between 1930 and 1950 in countries other than NO. Considering a lag time between Thorotrast use and liver cancer appearance, the large incidence peak around 1980 in DK and DE was probably contributed by Thorotrast but considering the ecological nature of the findings, the association should be considered cautiously as hypothesis generating. The late increase in liver cancer risk is most likely lifestyle related and largely preventable.
Subject: alcohol
hepatitis virus
hepatocellular carcinoma
risk factors
HEPATITIS-B
NORDIC COUNTRIES
FOLLOW-UP
LIVER
TRENDS
EPIDEMIOLOGY
MORTALITY
SURVIVAL
EU/EEA
RISK
3122 Cancers
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion


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