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Tanja Stocks

Tanja Stocks


Tanja Stocks

Metabolic risk factors and primary liver cancer in a prospective study of 578,700 adults


  • Wegene Borena
  • Susanne Strohmaier
  • Annekatrin Lukanova
  • Tone Bjorge
  • Bjorn Lindkvist
  • Goran Hallmans
  • Michael Edlinger
  • Tanja Stocks
  • Gabriele Nagel
  • Jonas Manjer
  • Anders Engeland
  • Randi Selmer
  • Christel Haggstrom
  • Steinar Tretli
  • Hans Concin
  • Hakan Jonsson
  • Par Stattin
  • Hanno Ulmer

Summary, in English

Initial studies have indicated diabetes and obesity to be risk factors for hepatocellular carcinoma; but the association between other metabolic risk factors and primary liver cancer (PLC) has not been investigated. The metabolic syndrome and cancer project (Me-Can) includes cohorts from Norway, Austria and Sweden with data on 578,700 subjects. We used Cox proportional hazard models to calculate relative risks (RRs) of PLC by body mass index (BMI), blood pressure and plasma levels of glucose, cholesterol and triglycerides as continuous standardized variables (z-score with mean = 0 and standard deviation (SD) = 1) and their standardized sum of metabolic syndrome (MetS) z-score. RRs were corrected for random error in measurements. During an average follow-up of 12.0 years (SD = 7.8), 266 PLCs were diagnosed among cohort members. RR of liver cancer per unit increment of z-score adjusted for age, smoking status and BMI and stratified by birth year, sex and sub-cohorts, was for BMI 1.39 (95% confidence interval (CI) 1.241.58), mid blood pressure 2.08 (0.954.73), blood glucose 2.13 (1.552.94) cholesterol 0.62 (0.510.76) and serum triglycerides 0.85 (0.651.10). The RR per one unit increment of the MetS z-score was 1.35 (1.121.61). BMI, glucose and a composite MetS score were positively and cholesterol negatively associated with risk of liver cancer.


  • EpiHealth: Epidemiology for Health
  • Surgery

Publishing year







International Journal of Cancer





Document type

Journal article


John Wiley and Sons


  • Cancer and Oncology


  • cohort study
  • epidemiology
  • hepatocellular carcinoma
  • intrahepatic
  • cholangiocarcinoma
  • metabolic syndrome



Research group

  • Surgery


  • ISSN: 0020-7136