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Hypothyroidism may increase liver cancer risk in women
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Data from an ongoing hospital-based case-control study indicate that women with a prior history of hypothyroidism may be at an increased risk for liver cancer. However, researchers are unclear about whether and why hypothyroidism causes liver cancer.
“Although hypothyroidism-associated weight gain may partially explain the association between hypothyroidism and hepatocellular carcinoma, hypothyroidism independent from obesity can also contribute to hepatocellular carcinoma development,” the researchers wrote. “Screening and proper management of thyroid diseases in patients with diabetes or hepatitis C virus infection may help prevent hepatocellular carcinoma.”
Researchers from M.D. Anderson Cancer Center in Houston examined demographic and liver cancer risk factor data from the records of 420 patients with newly diagnosed liver cancer and compared the data with 1,104 healthy controls.
Patients were questioned about their prior history of thyroid disorders. Those with a prior history of thyroid disorders were asked for age at diagnosis, duration of the disorder and treatment exposure.
Hepatitis C, cigarette use
A questionnaire about prior history of obesity was administered to 184 patients and 648 controls. Blood samples from 420 patients and 1,104 controls were tested for hepatitis B and hepatitis C.
A history of hepatitis C or hepatitis B, cigarette smoking, heavy alcohol consumption or having a family history of cancer or diabetes were significantly associated with liver cancer development, they reported in Hepatology.
Fifteen percent of patients with liver cancer had a history of thyroid disease compared with nearly 12% of healthy controls.
A significant interaction was found between gender and hypothyroidism on the development of liver cancer (P=.02). Women with a history of hypothyroidism had a twofold higher risk for liver cancer. In addition, women with a prior history of hypothyroidism for longer than 10 years had a threefold higher risk for liver cancer when compared with women without a history of thyroid disorders (P=.001).
The researchers observed a significant risk modification of combined hypothyroidism and hepatitis infection and combined diabetes and hepatitis infection in women.
According to the researchers, hypothyroidism may also play a role in the development of nonalcoholic steatohepatitis, further contributing to the susceptibility of liver cancer development.
“Further studies among different populations are warranted to confirm the association between hypothyroidism and hepatocellular carcinoma and to identify the underlying biological mechanisms and the genetic predisposition factors that may contribute to susceptibility to hepatocellular carcinoma development in the presence of thyroid disorders,” the researchers said.
Hassan M. Hepatology. 2009;49:1563-1570.