Background/aims: To assess the variability of liver cancer (LC) risk associated with hepatitis B (HBV) and hepatitis C (HCV) viruses and alcohol intake in 2002 throughout Europe.
Methods: Incidence data were obtained from population-based cancer registries whereas mortality, HBV, HCV and alcohol exposures were obtained from the WHO databases. Relative risk of LC and their posterior probabilities to be >1 were obtained and plotted in maps through a Bayesian random effects model.
Results: HBV prevalence >2% increased the risk of developing LC a 15% in men and 21% in women; HCV prevalence >2%, 54% in men and 33% in women and, pure alcohol intake >11l, 26% and 14%, respectively (all of them statistically significant). These risk factors played a similar role in the risk of dying from LC among men, whereas HBV and alcohol were not statistically significant among women. Significant high LC risk, after HBV/HCV and alcohol adjustment were observed for both sexes in: Hungary, Moldova, Romania, Croatia, Greece, Italy, Spain, France and Austria.
Conclusions: South-North and East-West decreasing gradients for LC risk were observed in Europe. HBV, alcohol and, mainly, HCV are independent risk factors that could explain this geographical pattern.