Familial Risks for Liver, Gallbladder and Bile Duct Cancers and for Their Risk Factors in Sweden, a Low-Incidence Country
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Family Relation | Men | Women | All | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | ||||
Family history (any first-degree relatives) | 168 | 1.70 | 1.45 | 1.98 | 136 | 1.82 | 1.53 | 2.15 | 304 | 1.75 | 1.56 | 1.96 |
Parents | 110 | 1.48 | 1.22 | 1.78 | 95 | 1.73 | 1.40 | 2.12 | 205 | 1.59 | 1.38 | 1.82 |
Father | 52 | 1.64 | 1.23 | 2.15 | 33 | 1.37 | 0.95 | 1.93 | 85 | 1.53 | 1.22 | 1.89 |
Mother | 58 | 1.38 | 1.05 | 1.79 | 64 | 2.02 | 1.55 | 2.58 | 122 | 1.66 | 1.37 | 1.98 |
Siblings | 59 | 2.09 | 1.59 | 2.69 | 43 | 2.07 | 1.50 | 2.79 | 102 | 2.08 | 1.69 | 2.52 |
One family member | 167 | 1.67 | 1.43 | 1.95 | 132 | 1.78 | 1.49 | 2.11 | 299 | 1.72 | 1.53 | 1.92 |
Two family members | 1 | 1.01 | 0.00 | 5.81 | 4 | 5.85 | 1.52 | 15.13 | 5 | 2.99 | 0.94 | 7.04 |
Cancer Type | Men | Women | All | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | ||||
Diagnosis of cases based on ICD-7, 1958–2018 | ||||||||||||
Hepatobiliary cancer | 180 | 1.80 | 1.55 | 2.09 | 139 | 1.85 | 1.56 | 2.18 | 319 | 1.82 | 1.63 | 2.04 |
Subtypes of hepatobiliary cancer in the study population | ||||||||||||
HCC | 120 | 2.01 | 1.67 | 2.41 | 49 | 2.64 | 1.96 | 3.50 | 169 | 2.16 | 1.85 | 2.51 |
Gallbladder cancer | 17 | 1.90 | 1.10 | 3.04 | 55 | 2.06 | 1.55 | 2.68 | 72 | 2.02 | 1.58 | 2.54 |
Intrahepatic bile duct cancer | 21 | 1.70 | 1.05 | 2.60 | 14 | 1.04 | 0.56 | 1.74 | 35 | 1.35 | 0.94 | 1.88 |
Extrahepatic bile duct cancer | 13 | 1.08 | 0.57 | 1.85 | 17 | 1.57 | 0.91 | 2.52 | 30 | 1.31 | 0.88 | 1.87 |
Ampulla of Vater cancer | 9 | 1.33 | 0.60 | 2.53 | 4 | 0.71 | 0.19 | 1.85 | 13 | 1.05 | 0.56 | 1.80 |
Diagnosis of cases based on ICD-10, 1997–2018 | ||||||||||||
Hepatobiliary cancer | 101 | 2.02 | 1.65 | 2.46 | 69 | 1.97 | 1.53 | 2.50 | 170 | 2.00 | 1.71 | 2.32 |
Subtypes of hepatobiliary cancer in the study population | ||||||||||||
HCC | 68 | 2.28 | 1.77 | 2.89 | 26 | 2.83 | 1.84 | 4.15 | 94 | 2.41 | 1.95 | 2.95 |
Gallbladder | 4 | 0.83 | 0.22 | 2.14 | 21 | 1.76 | 1.09 | 2.69 | 25 | 1.49 | 0.96 | 2.20 |
Intrahepatic bile duct | 16 | 2.50 | 1.42 | 4.07 | 8 | 1.24 | 0.53 | 2.45 | 24 | 1.87 | 1.19 | 2.78 |
Extrahepatic bile duct | 7 | 1.19 | 0.47 | 2.47 | 11 | 2.23 | 1.11 | 4.01 | 18 | 1.67 | 0.99 | 2.64 |
Ampulla of Vater | 6 | 1.96 | 0.70 | 4.29 | 3 | 1.22 | 0.23 | 3.63 | 9 | 1.63 | 0.74 | 3.11 |
Cancer in Family | Diagnoses Based on ICD-7, 1958–2018 | |||||||||||||||||||
HCC | Gallbladder | Extrahepatic Bile Ducts | Ampulla of Vater | |||||||||||||||||
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | |||||||||
HCC | 122 | 2.60 | 2.16 | 3.10 | 24 | 1.43 | 0.92 | 2.13 | 10 | 0.92 | 0.44 | 1.71 | 6 | 1.38 | 0.50 | 3.03 | ||||
Gallbladder | 50 | 1.32 | 0.98 | 1.74 | 39 | 2.76 | 1.96 | 3.77 | 12 | 1.30 | 0.67 | 2.28 | 2 | 0.55 | 0.05 | 2.02 | ||||
Extrahepatic bile ducts | 10 | 0.81 | 0.39 | 1.50 | 13 | 2.85 | 1.51 | 4.89 | 6 | 2.04 | 0.73 | 4.47 | 2 | 1.70 | 0.16 | 6.25 | ||||
Ampulla of Vater | 7 | 1.33 | 0.53 | 2.75 | 0 | 1 | 0.81 | 0.00 | 4.67 | 0 | ||||||||||
All | 189 | 1.85 | 1.59 | 2.13 | 76 | 2.04 | 1.60 | 2.55 | 29 | 1.20 | 0.80 | 1.72 | 10 | 1.04 | 0.49 | 1.91 | ||||
Cancer in Family | Diagnoses based on ICD-10, 1997–2018 | |||||||||||||||||||
HCC | Intrahepatic bile ducts | Gallbladder | Extrahepatic bile ducts | Ampulla of Vater | ||||||||||||||||
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | ||||||
HCC | 70 | 4.06 | 3.16 | 5.13 | 8 | 1.42 | 0.61 | 2.81 | 7 | 0.95 | 0.38 | 1.98 | 4 | 0.85 | 0.22 | 2.20 | 6 | 2.51 | 0.90 | 5.50 |
Intrahepatic bile ducts | 5 | 1.08 | 0.34 | 2.54 | 6 | 3.81 | 1.37 | 8.35 | 4 | 1.98 | 0.52 | 5.12 | 1 | 0.76 | 0.00 | 4.37 | 3 | 4.50 | 0.85 | 13.32 |
Gallbladder | 11 | 1.13 | 0.56 | 2.03 | 6 | 1.89 | 0.68 | 4.13 | 9 | 2.14 | 0.97 | 4.08 | 10 | 3.71 | 1.77 | 6.85 | 0 | |||
Extrahepatic bile ducts | 4 | 0.86 | 0.22 | 2.21 | 3 | 1.91 | 0.36 | 5.66 | 5 | 2.44 | 0.77 | 5.74 | 2 | 1.51 | 0.14 | 5.56 | 0 | |||
Ampulla of Vater | 4 | 1.47 | 0.38 | 3.81 | 1 | 1.11 | 0.00 | 6.37 | 0 | 1 | 1.31 | 0.00 | 7.48 | 0 | ||||||
All | 94 | 2.41 | 1.95 | 2.95 | 24 | 1.87 | 1.19 | 2.78 | 25 | 1.49 | 0.96 | 2.20 | 18 | 1.67 | 0.99 | 2.64 | 9 | 1.63 | 0.74 | 3.11 |
Cancer in Family | HCC | Gallbladder | Extrahepatic Bile Ducts | Ampulla of Vater | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | |||||
Upper aerodigestive tract | 117 | 1.15 | 0.95 | 1.38 | 43 | 1.19 | 0.86 | 1.61 | 25 | 1.06 | 0.69 | 1.57 | 11 | 1.17 | 0.58 | 2.09 |
Salivary gland | 10 | 0.95 | 0.45 | 1.75 | 2 | 0.55 | 0.05 | 2.03 | 2 | 0.83 | 0.08 | 3.05 | 2 | 2.02 | 0.19 | 7.44 |
Esophagus | 44 | 1.17 | 0.85 | 1.57 | 21 | 1.58 | 0.98 | 2.42 | 3 | 0.35 | 0.07 | 1.03 | 3 | 0.86 | 0.16 | 2.53 |
Stomach | 152 | 0.95 | 0.80 | 1.11 | 73 | 1.22 | 0.96 | 1.54 | 41 | 1.05 | 0.75 | 1.42 | 21 | 1.37 | 0.85 | 2.10 |
Small intestine | 19 | 0.95 | 0.57 | 1.48 | 6 | 0.86 | 0.31 | 1.89 | 10 | 2.18 | 1.04 | 4.02 | 4 | 2.16 | 0.56 | 5.59 |
Pancreas | 120 | 1.14 | 0.95 | 1.37 | 46 | 1.21 | 0.89 | 1.61 | 41 | 1.65 | 1.18 | 2.24 | 18 | 1.80 | 1.07 | 2.85 |
Colon | 300 | 0.95 | 0.85 | 1.07 | 103 | 0.92 | 0.75 | 1.11 | 94 | 1.28 | 1.03 | 1.57 | 48 | 1.60 | 1.18 | 2.13 |
Rectum | 156 | 0.96 | 0.81 | 1.12 | 70 | 1.20 | 0.94 | 1.52 | 33 | 0.87 | 0.60 | 1.22 | 16 | 1.04 | 0.59 | 1.69 |
Anus | 9 | 1.02 | 0.46 | 1.95 | 3 | 1.01 | 0.19 | 3.00 | 2 | 1.03 | 0.10 | 3.80 | 0 | |||
Lung | 384 | 1.36 | 1.23 | 1.51 | 102 | 1.04 | 0.85 | 1.26 | 67 | 1.05 | 0.82 | 1.34 | 29 | 1.12 | 0.75 | 1.62 |
Hepatobiliary | 189 | 1.85 | 1.59 | 2.13 | 76 | 2.04 | 1.60 | 2.55 | 29 | 1.20 | 0.80 | 1.72 | 10 | 1.04 | 0.49 | 1.91 |
Breast | 395 | 0.90 | 0.82 | 1.00 | 158 | 1.04 | 0.88 | 1.21 | 97 | 0.98 | 0.79 | 1.19 | 47 | 1.14 | 0.84 | 1.52 |
Cervix | 71 | 1.27 | 1.00 | 1.61 | 18 | 0.94 | 0.55 | 1.48 | 7 | 0.56 | 0.22 | 1.17 | 7 | 1.40 | 0.56 | 2.90 |
Endometrium | 108 | 1.07 | 0.87 | 1.29 | 35 | 0.98 | 0.68 | 1.36 | 17 | 0.73 | 0.42 | 1.17 | 7 | 0.74 | 0.29 | 1.53 |
Ovary | 60 | 0.87 | 0.67 | 1.12 | 21 | 0.87 | 0.54 | 1.33 | 17 | 1.07 | 0.62 | 1.72 | 3 | 0.46 | 0.09 | 1.37 |
Other female genitals | 10 | 0.67 | 0.32 | 1.25 | 8 | 1.49 | 0.64 | 2.96 | 4 | 1.15 | 0.30 | 2.97 | 0 | |||
Prostate | 419 | 0.91 | 0.82 | 1.00 | 147 | 0.91 | 0.76 | 1.06 | 76 | 0.71 | 0.56 | 0.89 | 27 | 0.62 | 0.41 | 0.90 |
Testis | 11 | 1.41 | 0.70 | 2.54 | 1 | 0.41 | 0.00 | 2.36 | 2 | 1.26 | 0.12 | 4.65 | 1 | 1.54 | 0.00 | 8.85 |
Other male genitals | 6 | 1.14 | 0.41 | 2.50 | 0 | 0.00 | 0.53 | 2.17 | 1 | 0.84 | 0.00 | 4.80 | 0 | |||
Kidney | 75 | 1.00 | 0.79 | 1.25 | 26 | 0.97 | 0.63 | 1.42 | 20 | 1.15 | 0.70 | 1.78 | 9 | 1.28 | 0.58 | 2.44 |
Bladder | 124 | 1.01 | 0.84 | 1.20 | 48 | 1.12 | 0.82 | 1.48 | 24 | 0.85 | 0.55 | 1.27 | 9 | 0.78 | 0.35 | 1.48 |
Melanoma | 84 | 0.99 | 0.79 | 1.22 | 33 | 1.17 | 0.80 | 1.64 | 28 | 1.52 | 1.01 | 2.19 | 8 | 1.02 | 0.44 | 2.03 |
Skin | 96 | 0.84 | 0.68 | 1.03 | 49 | 1.23 | 0.91 | 1.63 | 29 | 1.12 | 0.75 | 1.61 | 11 | 1.00 | 0.50 | 1.80 |
Eye | 7 | 1.07 | 0.42 | 2.21 | 4 | 1.72 | 0.45 | 4.44 | 2 | 1.32 | 0.12 | 4.84 | 0 | |||
Nervous system | 66 | 1.02 | 0.79 | 1.30 | 24 | 1.10 | 0.70 | 1.64 | 18 | 1.25 | 0.74 | 1.99 | 13 | 2.20 | 1.17 | 3.78 |
Thyroid | 20 | 1.18 | 0.72 | 1.82 | 4 | 0.68 | 0.18 | 1.77 | 1 | 0.26 | 0.00 | 1.51 | 2 | 1.31 | 0.12 | 4.82 |
Endocrine | 41 | 1.11 | 0.79 | 1.50 | 15 | 1.21 | 0.67 | 1.99 | 5 | 0.61 | 0.19 | 1.44 | 4 | 1.20 | 0.31 | 3.11 |
Bone | 0 | 0.00 | 0.29 | 1.19 | 2 | 1.85 | 0.17 | 6.81 | 1 | 1.41 | 0.00 | 8.09 | 0 | |||
Connective tissue | 17 | 1.24 | 0.72 | 2.00 | 2 | 0.43 | 0.04 | 1.58 | 2 | 0.64 | 0.06 | 2.37 | 0 | |||
Hodgkins disease | 6 | 0.62 | 0.22 | 1.36 | 5 | 1.50 | 0.47 | 3.52 | 3 | 1.37 | 0.26 | 4.04 | 3 | 3.45 | 0.65 | 10.21 |
Non-Hodgkins lymphoma | 53 | 0.80 | 0.60 | 1.05 | 31 | 1.35 | 0.92 | 1.92 | 12 | 0.80 | 0.41 | 1.40 | 5 | 0.81 | 0.26 | 1.91 |
Myeloma | 39 | 1.26 | 0.90 | 1.73 | 14 | 1.26 | 0.69 | 2.12 | 4 | 0.55 | 0.14 | 1.43 | 1 | 0.34 | 0.00 | 1.96 |
Leukemia | 66 | 0.97 | 0.75 | 1.24 | 22 | 0.94 | 0.59 | 1.43 | 10 | 0.65 | 0.31 | 1.20 | 4 | 0.64 | 0.17 | 1.64 |
Primary unknown | 67 | 1.06 | 0.82 | 1.35 | 22 | 0.98 | 0.61 | 1.49 | 19 | 1.30 | 0.78 | 2.04 | 5 | 0.85 | 0.27 | 2.00 |
Others | 5 | 1.01 | 0.32 | 2.37 | 1 | 0.60 | 0.00 | 3.42 | 1 | 0.88 | 0.00 | 5.06 | 1 | 2.20 | 0.00 | 12.60 |
All | 3377 | 1.04 | 1.00 | 1.07 | 1244 | 1.08 | 1.02 | 1.15 | 753 | 1.00 | 0.93 | 1.08 | 330 | 1.08 | 0.97 | 1.20 |
Hepatobiliary Cancer in Spouse | Wives | Husbands | All | |||||||||
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | ||||
Hepatobiliary cancer | 97 | 1.29 | 1.04 | 1.57 | 97 | 1.12 | 0.91 | 1.37 | 194 | 1.20 | 1.04 | 1.38 |
HCC | 64 | 1.33 | 1.02 | 1.70 | 37 | 1.33 | 0.94 | 1.84 | 101 | 1.33 | 1.08 | 1.62 |
Gallbladder | 17 | 1.30 | 0.75 | 2.08 | 46 | 1.04 | 0.76 | 1.39 | 63 | 1.10 | 0.85 | 1.41 |
Extrahepatic bile ducts | 10 | 1.09 | 0.52 | 2.01 | 9 | 0.86 | 0.39 | 1.64 | 19 | 0.97 | 0.58 | 1.51 |
Ampulla of vater | 6 | 1.22 | 0.44 | 2.67 | 5 | 1.20 | 0.38 | 2.83 | 11 | 1.21 | 0.60 | 2.18 |
Other cancers in spouse | Wives | Husbands | All | |||||||||
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | ||||
Upper aerodistive trac | 130 | 1.13 | 0.95 | 1.34 | 56 | 1.25 | 0.94 | 1.62 | 186 | 1.16 | 1.00 | 1.34 |
Stomach | 208 | 1.49 | 1.30 | 1.71 | 83 | 0.92 | 0.74 | 1.15 | 291 | 1.27 | 1.13 | 1.43 |
Pancreas | 123 | 1.26 | 1.04 | 1.50 | 90 | 0.92 | 0.74 | 1.13 | 213 | 1.09 | 0.95 | 1.25 |
Cervix | 138 | 1.19 | 1.00 | 1.40 | 138 | 1.19 | 1.00 | 1.40 |
Diagnosis of Comorbidities in Family | Men | Women | All | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | ||||
Alcohol-related liver disease | 345 | 1.79 | 1.61 | 1.99 | 196 | 1.34 | 1.16 | 1.54 | 541 | 1.60 | 1.47 | 1.74 |
Chronic obstructive pulmonary disease | 676 | 1.17 | 1.09 | 1.27 | 478 | 1.08 | 0.99 | 1.19 | 1154 | 1.14 | 1.07 | 1.20 |
Gallstone disease or operation | 3 | 0.41 | 0.08 | 1.23 | 6 | 1.17 | 0.42 | 2.55 | 9 | 0.73 | 0.33 | 1.39 |
Hepatitis B virus | 4 | 3.90 | 1.01 | 10.09 | 3 | 4.28 | 0.81 | 12.66 | 7 | 4.05 | 1.61 | 8.40 |
Hepatitis C virus | 1 | 0.28 | 0.00 | 1.60 | 2 | 0.76 | 0.07 | 2.78 | 3 | 0.48 | 0.09 | 1.42 |
Hepatitis of any kind | 12 | 1.49 | 0.77 | 2.61 | 5 | 0.84 | 0.26 | 1.97 | 17 | 1.21 | 0.71 | 1.95 |
Infection of bile ducts | 45 | 1.08 | 0.79 | 1.45 | 38 | 1.16 | 0.82 | 1.60 | 83 | 1.12 | 0.89 | 1.39 |
Autoimmune hepatitis | 27 | 1.21 | 0.80 | 1.77 | 13 | 0.77 | 0.41 | 1.32 | 40 | 1.02 | 0.73 | 1.39 |
Non-alcohol-related liver disease | 2 | 1.17 | 0.11 | 4.30 | 1 | 0.87 | 0.00 | 5.00 | 3 | 1.05 | 0.20 | 3.11 |
Obesity | 50 | 1.32 | 0.98 | 1.74 | 30 | 1.08 | 0.73 | 1.54 | 80 | 1.22 | 0.96 | 1.51 |
Primary biliary cirrhosis | 5 | 1.67 | 0.53 | 3.92 | 4 | 1.91 | 0.50 | 4.94 | 9 | 1.77 | 0.80 | 3.37 |
Diabetes | 1238 | 1.17 | 1.11 | 1.24 | 862 | 1.07 | 1.00 | 1.15 | 2100 | 1.13 | 1.08 | 1.18 |
All of above | 2408 | 1.23 | 1.19 | 1.28 | 1638 | 1.10 | 1.05 | 1.16 | 4046 | 1.18 | 1.14 | 1.21 |
Diagnosis of Comorbidities in Family | HCC | Gallbladder | Extrahepatic Bile Ducts | Ampulla of Vater | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | O | SIR | 95% CI | |||||
Alcohol-related liver disease | 414 | 2.00 | 1.81 | 2.20 | 63 | 0.95 | 0.73 | 1.22 | 47 | 1.00 | 0.74 | 1.34 | 17 | 0.91 | 0.53 | 1.46 |
Chronic obstructive pulmonary disease | 734 | 1.23 | 1.14 | 1.32 | 217 | 1.00 | 0.87 | 1.14 | 149 | 1.03 | 0.87 | 1.21 | 54 | 0.91 | 0.69 | 1.19 |
Gallstone disease or operation | 5 | 0.68 | 0.22 | 1.60 | 3 | 1.17 | 0.22 | 3.47 | 1 | 0.56 | 0.00 | 3.23 | 0 | |||
Hepatitis B viru | 7 | 5.20 | 2.06 | 10.77 | 0 | 0 | 0 | |||||||||
Hepatitis C virus | 3 | 0.69 | 0.13 | 2.03 | 0 | 0 | 0 | |||||||||
Hepatitis of any kind | 13 | 1.58 | 0.84 | 2.71 | 3 | 1.01 | 0.19 | 2.99 | 0 | 1 | 1.22 | 0.00 | 7.00 | |||
Infection of bile ducts | 51 | 1.22 | 0.91 | 1.60 | 17 | 1.00 | 0.58 | 1.60 | 6 | 0.56 | 0.20 | 1.22 | 9 | 2.01 | 0.91 | 3.84 |
Autoimmune hepatitis | 28 | 1.23 | 0.81 | 1.78 | 6 | 4 | 0.71 | 0.19 | 1.85 | 2 | ||||||
Non-alcohol-related liver disease | 2 | 1.07 | 0.10 | 3.95 | 1 | 2.21 | 0.00 | 12.65 | 0 | 0 | ||||||
Obesity | 55 | 1.28 | 0.97 | 1.67 | 17 | 1.51 | 0.88 | 2.42 | 4 | 0.47 | 0.12 | 1.22 | 4 | 1.26 | 0.33 | 3.25 |
Primary biliary cirrhosis | 8 | 2.58 | 1.10 | 5.12 | 0 | 1 | 1.36 | 0.00 | 7.82 | 0 | ||||||
Diabetes | 1271 | 1.18 | 1.12 | 1.25 | 418 | 1.02 | 0.93 | 1.13 | 281 | 1.05 | 0.93 | 1.18 | 130 | 1.20 | 1.00 | 1.43 |
All of above | 2591 | 1.29 | 1.24 | 1.34 | 745 | 1.01 | 0.94 | 1.09 | 493 | 1.01 | 0.92 | 1.10 | 217 | 1.09 | 0.95 | 1.25 |
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Hemminki, K.; Sundquist, K.; Sundquist, J.; Försti, A.; Liska, V.; Hemminki, A.; Li, X. Familial Risks for Liver, Gallbladder and Bile Duct Cancers and for Their Risk Factors in Sweden, a Low-Incidence Country. Cancers 2022, 14, 1938. https://doi.org/10.3390/cancers14081938
Hemminki K, Sundquist K, Sundquist J, Försti A, Liska V, Hemminki A, Li X. Familial Risks for Liver, Gallbladder and Bile Duct Cancers and for Their Risk Factors in Sweden, a Low-Incidence Country. Cancers. 2022; 14(8):1938. https://doi.org/10.3390/cancers14081938
Chicago/Turabian StyleHemminki, Kari, Kristina Sundquist, Jan Sundquist, Asta Försti, Vaclav Liska, Akseli Hemminki, and Xinjun Li. 2022. "Familial Risks for Liver, Gallbladder and Bile Duct Cancers and for Their Risk Factors in Sweden, a Low-Incidence Country" Cancers 14, no. 8: 1938. https://doi.org/10.3390/cancers14081938