Multiple Risk Factors for Liver Cirrhosis in Taiwan: A Cohort Study of Seven-township Residents who Participated in a Cancer Screening Program

• Main Authors: Shu-Ting, Luo, 羅淑婷
• Other Authors: Chien-An, Sun
• Format: Others
• Language: zh-TW
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/22373087208761208882

碩士 === 國防醫學院 === 公共衛生學研究所 === 92 === This cohort study of seven-township residents who participated in a cancer screening program was aiming to examine the incidence rates and multiple risk factors of liver cirrhosis in Taiwanese population. A total of 23783 residents, including 11889 males and 11894 females, who aged between 30-64 years at baseline recruitment from July 1990 to June 1992, were recruited for this cohort analysis. Hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and antibodies to hepatitis C virus (anti-HCV) in serum were determined by enzyme immunoassay, conventional liver function tests including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were determined by autoanalyzer. The habits of alcohol drinking, cigarette smoking and betel quid chewing were collected through standardized personal interview. The occurrence of liver cirrhosis among study subjects was assessed via data linkage with Injury Severity Registry and National Death Certificate System between 1991 and 2003. Cox proportional hazards model was used to calculate relative risks (RRs) and 95% confidence intervals (CIs). During the follow-up period, 103 incident cases with liver cirrhosis were identified, with an annual incidence rate of 40.47 per 100000 (95% confidence interval [CI] =33.56-49.38 per 100000), and a 12-year cumulative incidence of 1.41% (95% CI=1.11%-1.71%). The significant risk factors associated with the occurrence of liver cirrhosis based on multivariate analysis were positivity for HBsAg/HBeAg, anti-HCV, and use of betel quid. After controlling for age, gender, ethnicity and family history of liver cirrhosis/liver cancer, the RRs for HBsAg-positive and HBeAg-negative and positive for both HBsAg and HBeAg were 2.93 (95% CI=1.78-4.83) and 17.51 (95% CI=9.67-31.71), respectively, when those with negative for both HBsAg and HBeAg as the referent group. The RR associated with positivity for anti-HCV was 4.39 (95% CI=2.54-7.62) when compared with those negative for anti-HCV. The RR in relation to the use of betel quid was 2.99 (95% CI=1.45-6.14) as compared with those without the use of betel quid. In addition, population attributable risks associated with the aforementioned risk factors were 43.85% (95% CI=43.47%-43.97%) for HBsAg positivity, 14.78 % (95% CI=14.69%-14.87%) for anti-HCV positivity and 8.22% (95% CI=8.15%-8.29%) for the use of betel quid.