Alcohol consumption and hepatocellular carcinoma

A study investigated the association between heavy and low to moderate alcohol consumption and an increased risk of hepatocellular carcinoma.
Participants from the UK Biobank with detailed information on alcohol use and free of common diseases were included. Daily pure alcohol intake (g/day) was calculated, and the predominant alcoholic beverage type was assigned for each participant. Analyses were performed to evaluate the association of alcohol intake with hepatocellular carcinoma.
Of 329,164 participants (52.3% females, mean [SD] age = 56.7 [8.0] years), 201 incident hepatocellular carcinoma cases were recorded during the median follow-up of 12.6 years. Results suggested a J-shaped relationship between daily alcohol intake level and hepatocellular carcinoma risk. The J-shaped correlation pattern was detected only in subjects who mainly drank wine but not in those who mainly drank beer, spirits, or fortified wine. Moderate wine drinking showed a significant alanine transaminase (ALT)- and aspartate aminotransferase-lowering effect compared to that of the non-drinkers. In low-risk populations of hepatocellular carcinoma including women, people aged < 60 years, subjects with normal ALT levels, and those carrying non-risk genotypes of PNPLA3 rs738409 and TM6SF2 rs58542926, researchers observed a J-shaped correlation between alcohol use and hepatocellular carcinoma; however, a positive dose-response correlation was found in their respective counterparts, even in those predominantly drinking wine.
Low-to-moderate drinking may be inversely associated (protective) regarding the risk of hepatocellular carcinoma in low-risk populations, which may be largely driven by wine drinking. The authors recommend however that those in high-risk populations of hepatocellular carcinoma, such as men and older people, and those with abnormal ALT levels and carry genetic risk variants, should abstain from drinking alcohol. Given the small hepatocellular carcinoma case number, further validations with larger case numbers are warranted in future works.
Source: Liu, Z., Song, C., Suo, C. et al. Alcohol consumption and hepatocellular carcinoma: novel insights from a prospective cohort study and nonlinear Mendelian randomization analysis. BMC Med 20, 413 (2022).