Skip to main content

Variation in the risk for liver and gallbladder cancers in socioeconomic and occupational groups in Sweden with etiological implications

International Archives of Occupational and Environmental Health volume 78, pages 641–649 (2005)Cite this article

Abstract

Objectives: To examine the associations between socioeconomic/occupational factors and liver cancer at various anatomic sites (including primary liver, gallbladder and other cancers). Methods: We carried out a follow-up study on the economically active Swedish population, based on the Swedish Family-Cancer Database. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated in different social classes and occupations. Results: For primary liver cancer, farmers were at a decreased risk; increased risks were observed for male sales agents, journalists, seamen, waiters, cooks and female beverage manufacture workers. Similar patterns were observed for gallbladder cancer; workers employed as journalists, sales agents, cooks and stewards, and public safety workers showed increased risk. Only male transport workers showed increased risk of cancers in other parts. Conclusions: Occupations with high consumption of alcohol and/or high prevalence of smoking associated with a risk of liver and gallbladder cancers. The present study suggests that the effects of socioeconomic factors on liver cancer of different subsites are similar; alcohol drinking is a risk factor of gallbladder cancer because of the covariation of primary liver and gallbladder cancers in occupational groups.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  • Acalovschi M, Badea R, Dumitrascu D, Varga C (1988) Prevalence of gallstones in liver cirrhosis: a sonographic survey. Am J Gastroenterol 83:954–956

    PubMed  CAS  Google Scholar 

  • Adami HO, Hsing AW, McLaughlin JK, Trichopoulos D, Hacker D, Ekbom A, Persson I (1992) Alcoholism and liver cirrhosis in the etiology of primary liver cancer. Int J Cancer 51:898–902

    PubMed  Article  CAS  Google Scholar 

  • Andersen A, Barlow L, Engeland A, Kjaerheim K, Lynge E, Pukkala E (1999) Work-related cancer in the Nordic countries. Scand J Work Environ Health 25(Suppl 2):1–116

    PubMed  CAS  Google Scholar 

  • Blair A, Kazerouni N (1997) Reactive chemicals and cancer. Cancer Causes Control 8:473–490

    Article  PubMed  CAS  Google Scholar 

  • Carstensen JM, Pershagen G, Eklund G (1988) Smoking-adjusted incidence of lung cancer among Swedish men in different occupations. Int J Epidemiol 17:753–758

    PubMed  Article  CAS  Google Scholar 

  • Center for Epidemiology (1999) Cancer Incidence in Sweden 1997. The National Board of Health and Welfare, Stockholm

    Google Scholar 

  • Center for Epidemiology (2002) Cancer Incidence in Sweden 2000. The National Board of Health and Welfare, Stockholm

    Google Scholar 

  • Chow WH, McLaughlin JK, Zheng W, Blot WJ, Gao YT (1993) Occupational risks for primary liver cancer in Shanghai, China. Am J Ind Med 24:93–100

    PubMed  Article  CAS  Google Scholar 

  • Colombo M (1992) Hepatocellular carcinoma. J Hepatol 15:225–236

    Article  PubMed  CAS  Google Scholar 

  • Davey JD, Obst PL, Sheehan MC (2000) Developing a profile of alcohol consumption patterns of police officers in a large-scale sample of an Australian police service. Eur Addict Res 6:205–212

    Article  PubMed  CAS  Google Scholar 

  • Deuffic S, Poynard T, Buffat L, Valleron AJ (1998) Trends in primary liver cancer. Lancet 351:214–215

    Article  PubMed  CAS  Google Scholar 

  • Diehl AK (1983) Gallstone size and the risk of gallbladder cancer. JAMA 250:2323–2326

    Article  PubMed  CAS  Google Scholar 

  • Dubrow R, Wegman DH (1984) Cancer and occupation in Massachusetts: a death certificate study. Am J Ind Med 6:207–230

    PubMed  Article  CAS  Google Scholar 

  • El-Serag HB, Mason AC (1999) Rising incidence of hepatocellular carcinoma in the United States. N Engl J Med 340:745–750

    Article  PubMed  CAS  Google Scholar 

  • Fleisher JM (1990) Occupational and non-occupational risk factors in relation to an excess of primary liver cancer observed among residents of Brooklyn, New York. Cancer 65:180–185

    PubMed  Article  CAS  Google Scholar 

  • Fornari F, Civardi G, Buscarini E, Cavanna L, Imberti D, Rossi S, Sbolli G, Di Stasi M, Buscarini L (1990) Cirrhosis of the liver. A risk factor for development of cholelithiasis in males. Dig Dis Sci 35:1403–1408

    Article  PubMed  CAS  Google Scholar 

  • Godley PA, Sandler RS (1994) Liver cancer. In: Everhart JE (ed) Digestive diseases in the United States: epidemiology and impact. US Government Printing Office, Washington DC

    Google Scholar 

  • Hamilton SR, Aaltonen LA (2000) World Health Organization classification of tumours. Pathology and genetics of tumours of the digestive system. IARC Press, Lyon

    Google Scholar 

  • Hemmingsson T, Lundberg I, Romelsjo A, Alfredsson L (1997) Alcoholism in social classes and occupations in Sweden. Int J Epidemiol 26:584–591

    Article  PubMed  CAS  Google Scholar 

  • Hemminki K, Li X, Plna K, Granstrom C, Vaittinen P (2001) The nation-wide Swedish family-cancer database—updated structure and familial rates. Acta Oncol 40:772–777

    Article  PubMed  CAS  Google Scholar 

  • Hernberg S, Korkala ML, Asikainen U, Riala R (1984) Primary liver cancer and exposure to solvents. Int Arch Occup Environ Health 54:147–153

    Article  PubMed  CAS  Google Scholar 

  • Hoffmann G, Berglund G, Elmstahl S, Eriksson S, Verbaan H, Widell A, Lindgren S (2000) Prevalence and clinical spectrum of chronic viral hepatitis in a middle-aged Swedish general urban population. Scand J Gastroenterol 35:861–865

    Article  PubMed  CAS  Google Scholar 

  • Houten L, Sonnesso G (1980) Occupational exposure and cancer of the liver. Arch Environ Health 35:51–53

    PubMed  CAS  Google Scholar 

  • IARC (2004) IARC Monographs on the evaluation of the carcinogenic risk of chemicals to humans: tobacco smoke and involuntary smoking. World Health Organization, Lyon

    Google Scholar 

  • IARC: GLOBOCAN 2000 (2001) Cancer incidence, mortality and preventive worldwide. IARC, Lyon

    Google Scholar 

  • Inoue H, Seitz HK (2001) Viruses and alcohol in the pathogenesis of primary hepatic carcinoma. Eur J Cancer Prev 10:107–110

    Article  PubMed  CAS  Google Scholar 

  • Jensen OM (1979) Cancer morbidity and causes of death among Danish brewery workers. Int J Cancer 23:454–463

    PubMed  Article  CAS  Google Scholar 

  • Kauppinen T, Riala R, Seitsamo J, Hernberg S (1992) Primary liver cancer and occupational exposure. Scand J Work Environ Health 18:18–25

    PubMed  CAS  Google Scholar 

  • Khan ZR, Neugut AI, Ahsan H, Chabot JA (1999) Risk factors for biliary tract cancers. Am J Gastroenterol 94:149–152

    Article  PubMed  CAS  Google Scholar 

  • Kono S, Kochi S, Ohyama S, Wakisaka A (1988) Gallstones, serum lipids, and glucose tolerance among male officials of Self-Defense Forces in Japan. Dig Dis Sci 33:839–844

    Article  PubMed  CAS  Google Scholar 

  • Kuper H, Tzonou A, Kaklamani E, Hsieh CC, Lagiou P, Adami HO, Trichopoulos D, Stuver SO (2000) Tobacco smoking, alcohol consumption and their interaction in the causation of hepatocellular carcinoma. Int J Cancer 85:498–502

    Article  PubMed  CAS  Google Scholar 

  • Lazcano-Ponce EC, Miquel JF, Munoz N, Herrero R, Ferrecio C, Wistuba II, Alonso de Ruiz P, Aristi Urista G, Nervi F (2001) Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin 51:349–364

    PubMed  CAS  Google Scholar 

  • Lowenfels AB, Walker AM, Althaus DP, Townsend G, Domellof L (1989) Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol 18:50–54

    PubMed  Article  CAS  Google Scholar 

  • Maclure KM, Hayes KC, Colditz GA, Stampfer MJ, Speizer FE, Willett WC (1989) Weight, diet, and the risk of symptomatic gallstones in middle-aged women. N Engl J Med 321:563–569

    PubMed  CAS  Article  Google Scholar 

  • Maclure KM, Hayes KC, Colditz GA, Stampfer MJ, Willett WC (1990) Dietary predictors of symptom-associated gallstones in middle-aged women. Am J Clin Nutr 52:916–922

    PubMed  CAS  Google Scholar 

  • Moerman CJ, Bueno de Mesquita HB, Smeets FW, Runia S (1997) Lifestyle factors including diet and cancer of the gallbladder and bile duct: a population-based case-control study in The Netherlands. Eur J Cancer Prev 6:139–142

    PubMed  CAS  Google Scholar 

  • Okuda K, Fujimoto I, Hanai A, Urano Y (1987) Changing incidence of hepatocellular carcinoma in Japan. Cancer Res 47:4967–4972

    PubMed  CAS  Google Scholar 

  • Parkin DM, Pisani P, Ferlay J (1999) Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 80:827–841

    Article  PubMed  CAS  Google Scholar 

  • Pixley F, Wilson D, McPherson K, Mann J (1985) Effect of vegetarianism on development of gallstones in women. Br Med J (Clin Res Ed) 291:11–12

    CAS  Google Scholar 

  • Porru S, Placidi D, Carta A, Gelatti U, Ribero ML, Tagger A, Boffetta P, Donato F (2001) Primary liver cancer and occupation in men: a case-control study in a high-incidence area in Northern Italy. Int J Cancer 94:878–883

    Article  PubMed  CAS  Google Scholar 

  • Pukkala E (1995) Cancer risk by social class and occupations: a survey of 109,000 cancer cases among Finns of working age. Karger, Basel

    Google Scholar 

  • Ramstedt M (2001) Per capita alcohol consumption and liver cirrhosis mortality in 14 European countries. Addiction 96(Suppl 1):S19–S33

    Article  PubMed  Google Scholar 

  • Stemhagen A, Slade J, Altman R, Bill J (1983) Occupational risk factors and liver cancer. A retrospective case-control study of primary liver cancer in New Jersey. Am J Epidemiol 117:443–454

    PubMed  CAS  Google Scholar 

  • Strom BL, Soloway RD, Rios-Dalenz JL, Rodriguez-Martinez HA, West SL, Kinman JL, Polansky M, Berlin JA (1995) Risk factors for gallbladder cancer. An international collaborative case-control study. Cancer 76:1747–1756

    PubMed  Article  CAS  Google Scholar 

  • Taylor-Robinson SD, Foster GR, Arora S, Hargreaves S, Thomas HC (1997) Increase in primary liver cancer in the UK, 1979–1994. Lancet 350:1142–1143

    Article  PubMed  CAS  Google Scholar 

  • Tazuma S, Kajiyama G (2001) Carcinogenesis of malignant lesions of the gall bladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg 386:224–229

    Article  PubMed  CAS  Google Scholar 

  • Trichopoulos D, Day NE, Kaklamani E, Tzonou A, Munoz N, Zavitsanos X, Koumantaki Y, Trichopoulou A (1987) Hepatitis B virus, tobacco smoking and ethanol consumption in the etiology of hepatocellular carcinoma. Int J Cancer 39:45–49

    PubMed  Article  CAS  Google Scholar 

  • Tseng M, Everhart JE, Sandler RS (1999) Dietary intake and gallbladder disease: a review. Public Health Nutr 2:161–172

    PubMed  CAS  Article  Google Scholar 

  • Widell A, Verbaan H, Wejstal R, Kaczynski J, Kidd-Ljunggren K, Wallerstedt S (2000) Hepatocellular carcinoma in Sweden: its association with viral hepatitis, especially with hepatitis C viral genotypes. Scand J Infect Dis 32:147–152

    Article  PubMed  CAS  Google Scholar 

  • Williams CN, Johnston JL (1980) Prevalence of gallstones and risk factors in Caucasian women in a rural Canadian community. Can Med Assoc J 122:664–668

    PubMed  CAS  Google Scholar 

  • Zatonski WA, La Vecchia C, Przewozniak K, Maisonneuve P, Lowenfels AB, Boyle P (1992) Risk factors for gallbladder cancer: a Polish case-control study. Int J Cancer 51:707–711

    PubMed  Article  CAS  Google Scholar 

  • Zatonski WA, Lowenfels AB, Boyle P, Maisonneuve P, Bueno de Mesquita HB, Ghadirian P, Jain M, Przewozniak K, Baghurst P, Moerman CJ, Simard A, Howe GR, McMichael AJ, Hsieh CC, Walker AM (1997) Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer. J Natl Cancer Inst 89:1132–1138

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The Family-Cancer Database was created by linking registers maintained at Statistics Sweden and the Swedish Cancer Registry. The study was supported by the Swedish Cancer Society.

Author information

Affiliations

  1. Department of Bioscience at Novum, Karolinska Institutet, 14157, Huddinge, Sweden

    Jianguang Ji & Kari Hemminki

  2. Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany

    Kari Hemminki

Authors
  1. Jianguang Ji
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kari Hemminki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jianguang Ji.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ji, J., Hemminki, K. Variation in the risk for liver and gallbladder cancers in socioeconomic and occupational groups in Sweden with etiological implications. Int Arch Occup Environ Health 78, 641–649 (2005). https://doi.org/10.1007/s00420-005-0015-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-005-0015-1

Keywords

  • Liver cancer
  • Primary gall bladder cancer
  • Occupational exposures
  • Follow-up study