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Liver cirrhosis and cancer: comparison of mortality

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Abstract

Background

Liver cirrhosis is known to have low survival rate, and its assessment in relation with other fatal diseases will help us design appropriate health interventions. This study compares the mortality of liver cirrhosis with that of five major cancers (lung, colorectal, stomach, liver, and breast cancers).

Methods and results

We used the National Health Insurance Service–National Sample Cohort (NHIS–NSC) which provides data for 1,025,340 representative samples of the 46,605,433 people in Korea from 2002 to 2010. During the 8 years, 800 out of 2609 liver cirrhosis patients died and 1316 out of 4852 patients with the five major cancers died. When we estimated the mortality between liver cirrhosis and five major cancers, the relative mortality for liver cirrhosis was greater [hazard ratio 1.47 (95% CI 1.28–1.67) after age, gender, area of residence, type of insurance, insurance premium level (proxy for income level), and comorbidities were adjusted for]. When a sensitivity analysis was performed by excluding patients with both liver cirrhosis and one of the five cancers, the relative mortality was still greater for liver cirrhosis [hazard ratio 1.27 (95% CI 1.10–1.47)]. Furthermore, when we limited liver cirrhosis patients to those with decompensated liver cirrhosis, the relative mortality of decompensated liver cirrhosis was even greater than that of the five cancers [hazard ratio 1.82 (95% CI 1.51–2.20)].

Conclusions

The mortality of liver cirrhosis is greater than that of the five major cancers. This implies the need to prioritize appropriate health interventions for liver cirrhosis.

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Acknowledgements

This study was presented at the annual conference of the American Association for the Study of Liver Diseases (AASLD) [Hepatology 2017;66(Suppl 1):95A]. We would like to thank for the help of Ki Tae Suk, M.D., and Sang Hyun Choi, M.D., in preparation of the presentation at The Liver Meeting 2017.

Funding

This study was supported by the Korean Association for the Study of the Liver (KASL) and the Korean Liver Foundation. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, South Korea

    Wankyo Chung

  2. College of International Studies, Hallym University, Chuncheon, South Korea

    Changik Jo

  3. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea

    Woo Jin Chung

  4. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea

    Dong Joon Kim

  5. Center for Liver and Digestive Diseases, 77 Sakju-ro, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Gangwon-do, 24253, South Korea

    Dong Joon Kim

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  1. Wankyo Chung
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Corresponding author

Correspondence to Dong Joon Kim.

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Conflict of interest

Wankyo Chung, Changik Jo, Woo Jin Chung, and Dong Joon Kim have declared that no competing interests exist.

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Chung, W., Jo, C., Chung, W.J. et al. Liver cirrhosis and cancer: comparison of mortality. Hepatol Int 12, 269–276 (2018). https://doi.org/10.1007/s12072-018-9850-5

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  • DOI: https://doi.org/10.1007/s12072-018-9850-5

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