One hundred seven Chinese patients with primary hepatocellular carcinoma (PHC) were compared with 107 hospital controls for the presence of hepatitis B surface antigen and smoking, drinking, and dietary habits. Eighty-two % of PHC cases were hepatitis B surface antigen positive compared to 18% of controls (relative risk, 21.3; 95% confidence limits, 10.1 and 45.9). Prior history of jaundice was significantly related to PHC, independent of hepatitis B surface antigen status. There was a significant association between cigarette smoking and PHC negative for hepatitis B surface antigen. The relative risk of hepatitis B surface antigen-negative PHC for heavy smokers (20+ cigarettes/day) was 3.3 compared to light smokers and nonsmokers (95% confidence limits, 1.0 and 13.4). Our data indicated that infection by the hepatitis B virus and cigarette smoking were independent risk factors for PHC.


Supported by Grants CA 14089 and CA 17054 from the National Cancer Institute of the NIH.

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