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Penetrance, cancer incidence and survival in HFE haemochromatosis-A population-based cohort study.
Liver Int. 44, 838-847 (2024)
BACKGROUND AND AIMS: Haemochromatosis is characterized by progressive iron overload affecting the liver and can cause cirrhosis and hepatocellular carcinoma. Most haemochromatosis patients are homozygous for p.C282Y in HFE, but only a minority of individuals with this genotype will develop the disease. The aim was to assess the penetrance of iron overload, fibrosis, hepatocellular carcinoma and life expectancy. METHODS: A total of 8839 individuals from the Austrian region of Tyrol were genotyped for the p.C282Y variant between 1997 and 2021. Demographic, laboratory parameters and causes of death were assessed from health records. Penetrance, survival, and cancer incidence were ascertained from diagnosed cases, insurance- and cancer registry data. Outcomes were compared with a propensity score-matched control population. RESULTS: Median age at diagnosis in 542 p.C282Y homozygous individuals was 47.8 years (64% male). At genotyping, the prevalence of iron overload was 55%. The cumulative penetrance of haemochromatosis defined as the presence of provisional iron overload was 24.2% in males and 10.5% in females aged 60 years or younger. Among p.C282Y homozygotes of the same ages, the cumulative proportion of individuals without fibrosis (FIB-4 score < 1.3) was 92.8% in males and 96.7% in females. Median life expectancy was reduced by 6.8 years in individuals homozygous for p.C282Y when compared with population-matched controls (p = .001). Hepatocellular carcinoma incidence was not significantly higher in p.C282Y homozygotes than in controls matched for age and sex. CONCLUSION: Reduced survival and the observed age-dependent increase in penetrance among p.C282Y homozygotes call for earlier diagnosis of haemochromatosis to prevent complications.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Fib-4 ; Fibrosis ; Hepatocellular Carcinoma ; Iron Overload ; Malignancy; Hereditary Hemochromatosis; General-population; Disease; Liver; Association; Relatives; Mortality; Fibrosis
ISSN (print) / ISBN
1478-3223
e-ISSN
1478-3231
Journal
Liver International
Quellenangaben
Volume: 44,
Issue: 3,
Pages: 838-847
Publisher
Blackwell
Publishing Place
Oxford
Non-patent literature
Publications
Institute(s)
Institute of Epidemiology II (EPI2)
Grants
Austrian Federal Ministry for Digital and Economic Affairs
Christian Doppler Forschungsgesellschaft
Christian Doppler Forschungsgesellschaft