Synergistic effect of oral corticosteroids use on risk of hepatocellular carcinoma in high risk populations

Associations of exposure to arsenic species and endogenous sex hormones with oral cancer: a hospital-based study in Southeastern China

The effects of arsenic species and endogenous sex hormones on oral cancer risk, particularly their molecular interactions, have been infrequently reported. This study aimed to assess the individual and combined effects of arsenic species and endogenous sex hormones on oral cancer risk and elucidate the association between hormones, arsenic species, and arsenic metabolism. A case-control study (comprising 144 cases and 144 controls) was conducted from January 2020 to January 2024 in Southeastern China. Serum levels of six arsenic species and nine endogenous sex hormones were measured using High-Performance Liquid Chromatography Inductively Coupled Plasma Mass Spectrometry (HPLC-ICP-MS) and ultra-high performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS), respectively. After adjusting for potential confounders, Logistic regression showed that high exposure levels of inorganic arsenic (IAs) (adjusted OR [aOR] and 95 %CI: 0.00[0.00,0.44] and 0.45[0.25,0.78]) and Cortisone (aOR and 95 %CI: 0.16[0.07,0.35] and 0.19[0.10,0.37]) were associated with reduced oral cancer risk, both as continuous and categorical variables. Serum Melatonin, Cortisone, and Testosterone levels correlated with partial arsenic species, while Cortisone and Melatonin were linked to arsenic methylation metabolic indexes (spearman's test P < 0.05). Quantile g-computation analysis revealed that Corticosterone and Cortisone had the largest positive and negative weights on oral cancer risk, respectively (weights = 0.640 and 0.525). The combined effect of arsenic species and hormones on oral cancer was protective (β and 95 %CI: 0.36(-0.05,-0.67)), with slight gender differences. Independent of other arsenic species and hormone levels, Cortisone exhibited a protective effect against oral cancer in BKMR analysis. Additionally, an interaction effect between Melatonin and other arsenic species was also observed. In summary, Serum IAs and Cortisone were negatively associated with oral cancer, while Corticosterone showed a positive association. Further cohort studies are needed to confirm and elucidate these mechanisms.

Liver Cancer Etiology: Old Issues and New Perspectives

PURPOSE OF REVIEW

This review aims to synthesize the old issues and current understandings of the etiology of liver cancer, focusing on the diverse causative factors influenced by geographical, socioeconomic, and lifestyle variations across different regions.

RECENT FINDINGS

We highlight significant geographic disparities in liver cancer risk factors. While hepatitis B and C viruses, aflatoxin exposure, and alcohol consumption remain globally established contributors; metabolic dysfunction-associated steatotic liver disease and metabolic syndromes are increasingly prominent in the West. Chronic HBV and aflatoxin continue to dominate as risk factors in Asia and Africa. Dietary factors, metabolic diseases like diabetes and obesity, genetic predispositions, environmental risk factors and lifestyle choices such as smoking and alcohol use play substantial roles in specific populations. Protective factors like coffee and tea consumption, along with aspirin use, vegetables and fruits have shown potential in reducing HCC risk, although findings vary by population and dietary habits. Liver cancer etiology is influenced by various factors that differ by region. Established risk factors include hepatitis B and C, aflatoxin, and alcohol. Emerging risks, such as metabolic dysfunction-associated steatotic liver disease, are more prevalent in Western countries, while aflatoxin and HBV remains significant in Asia and Africa. Diet, metabolic conditions like diabetes and obesity, genetic predispositions, and lifestyle choices also play crucial roles. Coffee, tea, aspirin, vegetables, and fruits may reduce HCC risk, but effectiveness varies. Future research should integrate epidemiology, genetics, and nutrition, with global cooperation and data sharing essential for effective cancer control strategies.

Long-Term Glucocorticoid Use and Cancer Risk: A Population-Based Cohort Study in South Korea

Long-term glucocorticoid (GC) exposure causes immunosuppression; therefore, the risk of cancer may be increased in long-term GC users. We investigated whether long-term GC use is associated with a higher risk of cancer in the population without cancer. A population-based cohort study using data from the National Health Insurance Service was conducted among the South Korean adult population in 2010. Long-term GC users were defined as those who were prescribed a continuous supply of oral GC for ≥30 days. The primary endpoint was a new cancer diagnosis from January 1, 2011, to December 31, 2015. Among 770,880 individuals included in the analysis, 1,602 (0.2%) were long-term GC users and 36,157 (4.7%) were newly diagnosed with cancer from January 2011 to December 2015. In the multivariable Cox regression analysis, the risk of cancer among long-term GC users was 1.23-fold higher than that of the unexposed individuals [95% confidence interval (CI), 1.06-1.43; P = 0.007]. In the competing risk analyses, the risks of liver cancer and lung cancer were 1.46-fold (95% CI, 1.03-2.07; P = 0.034) and 1.52-fold (95% CI, 1.04-2.21; P = 0.029) higher in the long-term GC users than that of the unexposed individuals, respectively. We found that long-term GC exposure might be associated with a higher risk of overall cancer, and this association was more evident for lung and liver cancer risk. However, because there might be unmeasured and potential confounders in this study, the results should be interpreted carefully, and future studies should be performed to confirm these findings. IMPACT: Long-term glucocorticoid therapy might be associated with a higher cancer risk. This association was more evident for lung and liver cancer risk. Our findings suggest that long-term prescriptions of glucocorticoids should be administered carefully considering the risk of cancer.