Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012;17(11):1461-8.
doi: 10.1634/theoncologist.2012-0066. Epub 2012 Sep 6.

Body mass index and risk of primary liver cancer: a meta-analysis of prospective studies

Yuqin Wang  1 , Baochan Wang, Feng Shen, Jiangao Fan, Haixia Cao
Affiliations
Meta-Analysis

Body mass index and risk of primary liver cancer: a meta-analysis of prospective studies

Yuqin Wang et al. Oncologist. 2012.

Abstract

Background: Questions remain about the dose-response relationship between body mass index (BMI) and primary liver cancer (PLC) risk, possible confounding by hepatitis virus infection, and differences by gender or geographic location. We performed a meta-analysis of prospective studies to explore these issues.

Methods: We searched PubMed and Embase for studies of BMI and risk of PLC through November 30, 2011. Summary relative risks with their corresponding 95% confidence intervals (CIs) were calculated using a random effects model.

Results: A total of 21 prospective studies (including 17,624 PLC cases) were included in our analysis. The summary relative risk for a 5-unit increment in BMI (in kg/m(2)) was 1.39 (95% CI: 1.25-1.55), with high heterogeneity. These positive results were robust when stratified by sex, geographic location, ascertainment of exposure and outcome, the number of cases, duration of follow-up, sample source, and cofounders. There was evidence of a nonlinear association between BMI and PLC risk, with the most pronounced increase in risk among persons with a BMI >32 kg/m(2). Patients with hepatitis C virus or cirrhosis (but not patients with hepatitis B virus) with excess weight had a higher risk of PLC development than general populations with excess weight.

Conclusion: Excess weight increases PLC risk. For people with HCV infection or cirrhosis, risk increases are greater than for general population.

PubMed Disclaimer

Conflict of interest statement

Disclosures: The authors indicated no financial relationships.

Figures

Figure 1.
Figure 1.
Flow diagram of study selection. Abbreviation: HIV, human immunodeficiency virus.
Figure 2.
Figure 2.
Forest plots of risk of primary liver cancer associated with each 5-unit increase in BMI (in kg/m2). *Derived by pooling the sex-specific relative risks. **Derived from each 1-unit increment of body mass index. Abbreviations: CI, confidence interval; RR, relative risk.
Figure 3.
Figure 3.
Body mass index and primary liver cancer risk, nonlinear dose-risk relationship. Abbreviation: RR, relative risk.
See this image and copyright information in PMC

References

    1. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: Epidemiology and molecular carcinogenesis. Gastroenterology. 2007;132:2557–2576. - PubMed
    1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917. - PubMed
    1. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24:2137–2150. - PubMed
    1. El-Serag HB, Mason AC. Risk factors for the rising rates of primary liver cancer in the United States. Arch Intern Med. 2000;160:3227–3230. - PubMed
    1. Yu MC, Yuan JM. Environmental factors and risk for hepatocellular carcinoma. Gastroenterology. 2004;127:S72–78. - PubMed

Publication types