Alcohol Epidemiologic Data System, CSR Incorporated, 2107 Wilson Boulevard, Suite 1000, Arlington, Virginia 22201-3085, USA.
J Stud Alcohol Drugs. 2011 Nov;72(6):892-902. doi: 10.15288/jsad.2011.72.892.
The incidence rate of hepatocellular carcinoma has been rising in the United States during the last 2 decades. Heavy alcohol use has been widely recognized as one of the major etiological factors of hepatocellular carcinoma. This study sought to assess the extent to which heavy alcohol use contributed to premature death from hepatocellular carcinoma on a population scale in the United States.
We analyzed the Multiple Cause of Death public-use data sets. Using codes from the International Classification of Diseases, 10th Revision, hepatocellular carcinoma death was defined based on the underlying cause of death, and heavy alcohol use was indicated by the presence of any alcohol-induced medical conditions among the contributing causes of death. During 1999-2006 in the United States, 51,400 hepatocellular carcinoma deaths were identified from 17,727,245 natural deaths of persons age 25 or older. We conducted Poisson regression, life table, and multiple linear regression analyses to compare prevalence ratios, cumulative probabilities, and mean ages of death, respectively, from hepatocellular carcinoma by heavy alcohol use status across sex and race/ethnicity.
Heavy alcohol use decedents had higher prevalence ratios of dying from hepatocellular carcinoma than from non-chronic liver diseases compared with those decedents without heavy alcohol use. Heavy alcohol use was associated with decreased mean ages and increased cumulative probabilities of death among hepatocellular carcinoma decedents across racial/ethnic groups in both sexes. This association was stronger among women than men and stronger among non-Hispanic Whites than non-Hispanic Blacks.
This study provides mortality-based empirical evidence to further establish heavy alcohol consumption as one of the key risk factors contributing to premature deaths from hepatocellular carcinoma in the United States, and its effect appears more prominent among women and non-Hispanic Whites.
在过去的 20 年中，美国的肝细胞癌发病率一直在上升。大量饮酒已被广泛认为是肝细胞癌的主要病因之一。本研究旨在评估在美国人群中，大量饮酒在多大程度上导致肝细胞癌的过早死亡。
我们分析了多死因公共使用数据集。使用国际疾病分类第 10 版的代码，根据死亡的根本原因定义肝细胞癌死亡，根据死亡的促成原因中是否存在任何与酒精有关的医疗状况来确定大量饮酒。1999 年至 2006 年期间，在美国，从年龄在 25 岁及以上的 1772.7245 例自然死亡中，共确定了 51400 例肝细胞癌死亡。我们分别进行泊松回归、寿命表和多元线性回归分析，以比较男女和种族/族裔之间大量饮酒状态与非慢性肝病相比，死于肝细胞癌的患病率比、累积死亡率和平均死亡年龄。
与非大量饮酒者相比，大量饮酒者死于肝细胞癌的患病率比死于非慢性肝病的患病率更高。大量饮酒与男女各种族/族裔的肝细胞癌死亡者的平均年龄降低和累积死亡率增加有关。这种关联在女性中比男性更强，在非西班牙裔白种人比非西班牙裔黑种人中更强。
本研究提供了基于死亡率的经验证据，进一步确立了大量饮酒是导致美国肝细胞癌过早死亡的关键危险因素之一，其影响在女性和非西班牙裔白种人中更为显著。
