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There is scarcity of the published data on the risk factors for HCC in the Gulf Cooperation Council countries specifically Kuwait. Therefore, this case-control study sought to examine the risk factors associated with HCC in Kuwait.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Fifty-three histopathologically confirmed HCC cases were recruited from the Kuwait Cancer Control Center Registry. One hundred ninety-six controls (1:4 ratio) were selected from medical and\/ or surgical outpatient\u2019s clinics at all six public hospitals of Kuwait. A structured questionnaire was used to collect the data both from cases and controls through face-to-face interviews. A multivariable logistic regression model was fitted to the case-control data. Adjusted odds ratios (OR<jats:sub>adj<\/jats:sub>) and their 95% confidence intervals (CI) were computed using the parameters\u2019 estimates of the final model and used for interpretation of the model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The HCC cases compared with the controls were 41.6 times more likely to have had the history of non-alcoholic fatty liver disease (NAFLD) (OR<jats:sub>adj<\/jats:sub> = 41.6; 95% CI: 8.9\u2013193.5; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The cases compared with the controls were more likely to have reported the history of heavy alcohol drinking (OR<jats:sub>adj<\/jats:sub> = 14.2; 95% CI: 1.2\u2013173.4; <jats:italic>p<\/jats:italic>\u2009=\u20090.038). Furthermore, compared with the controls, the HCC cases tended to frequently consume milk and\/or milk substitutes (\u2265 3 glass\/ week) (OR<jats:sub>adj<\/jats:sub> = 7.2; 95% CI: 1.2\u201343.4). Conversely however, there was a significant protective effect if the participants reportedly have had regularly used olive oil in their routine diet as a source of fat (OR<jats:sub>adj<\/jats:sub> = 0.17; 95% CI: 0.04\u20130.80) or regularly used non-steroid anti-inflammatory drugs (NSAIDs) (OR<jats:sub>adj<\/jats:sub> = 0.20; 95% CI: 0.05\u20130.71).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This study showed that heavy alcohol consumption, NAFLD history, and excessive consumption of milk\/ milk substitutes were associated with a significantly increased HCC risk. Conversely however, regular use of olive oil in the diet as a source of fat or regular use of NSAIDs had a significantly protective effect against HCC risk. Adapting healthy dietary habits and preventing\/ treating NAFLD may minimize the HCC risk. Future research with a larger sample size may contemplate validating the results of this study and unraveling additional risk factors contributing to HCC risk. The resultant data may help design and implement evidence-based educational programs for the prevention of HCC in this and other similar settings.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-024-12409-0","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T12:06:03Z","timestamp":1717675563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diet, lifestyle factors, comorbidities, and hepatocellular carcinoma risk in a middle eastern country: a case-control study"],"prefix":"10.1186","volume":"24","author":[{"given":"Shaimaa","family":"Almohaid","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1261-788X","authenticated-orcid":false,"given":"Saeed","family":"Akhtar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,6]]},"reference":[{"issue":"13","key":"12409_CR1","doi-asserted-by":"publisher","first-page":"1550","DOI":"10.3748\/wjg.v25.i13.1550","volume":"25","author":"PS Harris","year":"2019","unstructured":"Harris PS, Hansen RM, Gray ME, Massoud OI, McGuire BM, Shoreibah MG. 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