{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:25:02Z","timestamp":1791347102260,"version":"4.3.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,7,20]],"date-time":"2017-07-20T00:00:00Z","timestamp":1500508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute hepatic porphyria (<jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content>) is considered to be a risk factor for primary liver cancer (<jats:styled-content style=\"fixed-case\">PLC<\/jats:styled-content>), but varying risk estimates have been published.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our aim was to investigate the risk of <jats:styled-content style=\"fixed-case\">PLC<\/jats:styled-content> and other cancers in persons with <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content> using a nationwide cohort design. Given that greater numbers of women than men tend to have manifest and more severe <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content>, a further aim was to investigate sex differences in this risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study sample consisted of all Norwegian residents aged 18 years or older during the period 2000\u20132011. Persons with <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content> (<jats:italic>n<\/jats:italic> = 251) were identified through the Norwegian Porphyria Centre, and patients with a cancer diagnosis were identified by linkage to the Cancer Registry of Norway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For persons with <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content>, the annual incidence rate of <jats:styled-content style=\"fixed-case\">PLC<\/jats:styled-content> was 0.35%. <jats:styled-content style=\"fixed-case\">PLC<\/jats:styled-content> risk was substantially higher for individuals with an <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content> diagnosis compared to the reference population [adjusted hazard ratio (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content>) 108, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 56\u2013207]. In a meta\u2010analysis of published studies on <jats:styled-content style=\"fixed-case\">PLC<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content>, including ours, women had a higher risk than men. In addition, our results suggested that persons with <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content> may have increased risks of kidney (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> 7.4, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.4\u201323.1) and endometrial cancers (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> 6.2, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.0\u201319.3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings confirmed a substantially higher risk of <jats:styled-content style=\"fixed-case\">PLC<\/jats:styled-content> associated with <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content> compared to the general population. In a meta\u2010analysis, the risk was shown to be greater for women than men. The novel findings of a moderate to substantial association between <jats:styled-content style=\"fixed-case\">AHP<\/jats:styled-content> and kidney and endometrial cancers should be investigated further.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.12646","type":"journal-article","created":{"date-parts":[[2017,7,21]],"date-time":"2017-07-21T08:11:57Z","timestamp":1500624717000},"page":"229-240","source":"Crossref","is-referenced-by-count":46,"title":["Acute hepatic porphyria and cancer risk: a nationwide cohort study"],"prefix":"10.1111","volume":"282","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7772-5315","authenticated-orcid":false,"given":"C. 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K.","family":"Aarsand","sequence":"additional","affiliation":[{"name":"Norwegian Porphyria Centre (NAPOS) Laboratory of Clinical Biochemistry Haukeland University Hospital Bergen Norway"},{"name":"Norwegian Quality Improvement of Laboratory Examinations (NOKLUS) Haraldsplass Deaconess Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. M.","family":"Nilsen","sequence":"additional","affiliation":[{"name":"Western Norway University of Applied Sciences Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"Toll\u00e5nes","sequence":"additional","affiliation":[{"name":"Centre for Disease Burden Domain for Mental and Physical Health Norwegian Institute of Public Health Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365510902935979"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1992.tb00949.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4045\/tidsskr.13.0649"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-012-9544-4"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1994.tb01279.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2010.02335.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0954-6820.1984.tb05005.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)80097-5"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.1996.21847000.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1988.23"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009745"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-012-9576-9"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.12.005"},{"key":"e_1_2_8_15_1","first-page":"17","article-title":"Is 5\u2010aminolevulinic acid involved in the hepatocellular carcinogenesis of acute intermittent porphyria?","volume":"48","author":"Onuki J","year":"2002","journal-title":"Cell Mol Biol (Noisy\u2010le\u2010grand)"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/1011-1344(93)80127-U"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/8904_2015_406"},{"key":"e_1_2_8_18_1","unstructured":"Nasjonalt servicemilj\u00f8 for medisinske kvalitetsregistre. 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