Liver cirrhosis and cancer: comparison of mortality
- 180 Downloads
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)].
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.
KeywordsLiver cirrhosis Cancer Mortality
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.
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.
Compliance with ethical standards
Conflict of interest
Wankyo Chung, Changik Jo, Woo Jin Chung, and Dong Joon Kim have declared that no competing interests exist.
- 10.Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology 2014;60:715–735CrossRefPubMedGoogle Scholar
- 13.Global Burden of Disease Cancer Collaboration. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015. A systematic analysis for the Global Burden of Disease Study. JAMA Oncol 2017;3:524–548CrossRefGoogle Scholar
- 20.WHO. WHO methods and data sources for country-level causes of death 2000–2015. Global Health Estimates Technical Paper WHO/HIS/IER/GHE/2016.3Google Scholar
- 25.Kim CY, Kim JW, Lee HS, Yoon YB, Song IS. Natural history and survival rate of chronic liver diseases in Korea—20 years prospective analysis. Korean J Med 1994;46:168–180Google Scholar