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The relationship of folate and alcohol to hepatocellular carcinoma incidence and liver disease mortality

Thursday, October 11, 2012 — Poster Session III

10:00 a.m. – Noon

Natcher Conference Center, Building 45



* FARE Award Winner


  • E.C. Persson
  • L. Schwartz
  • Y. Park
  • A.R. Hollenbeck
  • B.I. Graubard
  • N.D. Freedman
  • K.A. McGlynn


Introduction: Alcohol intake increases the risk of liver disease and hepatocellular carcinoma(HCC). Alcohol consumption also inhibits the absorption of folate. Folate intake has been inversely associated with liver damage and HCC. To examine whether high folate intake altered the relationship between alcohol and liver disease mortality or HCC incidence, we analyzed data from the NIH-AARP Cohort Study. Methods: Alcohol consumption and folate intake were determined by a food-frequency questionnaire. Alcohol intake was categorized into drinks/day and daily folate intake was categorized into tertiles. Adjusted hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards regression. Results: Liver disease mortality and HCC incidence were significantly associated with intake of >3drinks/day. Folate had no effect on the relationship between alcohol and liver disease mortality, but affected the relationship between alcohol and HCC. High alcohol consumption increased the risk of HCC among persons whose folate intake was in the lower tertiles. Conclusion: Liver disease mortality was associated with increased alcohol consumption, regardless of folate intake. HCC incidence was associated with increased alcohol consumption only among persons with folate intake in the lower two tertiles, suggesting that high folate intake may ameliorate the effects of alcohol consumption on the development of HCC.

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