A HOSPITAL-BASED CASE-CONTROL STUDY ON HEPATOCELLULAR-CARCINOMA IN FUKUOKA AND SAGA PREFECTURES, NORTHERN KYUSHU, JAPAN

Three hundred and sixty-eight case-control sets (male 287 pairs; female 81 sets) were collected for a hospital-based case-control study of primary hepatocellular carcinoma (HCC) conducted in Northern Kyushu, Japan. All incident cases of HCC were collected weekly from the inpatients (aged 40-69) of the Second Department of Internal Medicine, Kurume University Hospital between April, 1986 and May, 1992. One control for a male case and 4 controls for a female case were sampled, being matched to a case on age (same 5-year age class), sex, residence (prefecture) and time of hospitalization (within 2 months after a case interview) from the inpatients of two general hospitals in Kurume. Information was collected by interview in person by a well-trained interviewer and from a review of hospital records by the authors. Multivariate analyses based on a conditional logistic regression model without an interaction term revealed that hepatitis B surface antigen (HBsAg) positive status (odds ratio (OR) = 8.67; 95% confidence interval (95%CI) = 2.54-29.57), history of blood transfusion over 10 years previously (2.40; 1.26-4.56), parental history of hepatic diseases (2.31; 1.11-4.80) and heavy alcohol drinking (60 less-than-or-equal-to drink-years) by age 40 (3.23; 1.61-6.51) were statistically significant risk factors of male HCC. Univariate analysis for females also showed an elevated OR of HBsAg (7.58; 1.96-29.35). Although the sample size was limited, univariate analysis indicated that anti-hepatitis C virus antibody by c100-3 antigen positive status had a statistically significant OR for HCC in both sexes.