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Kyungdo Han

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Open access Aug 2026

The impact of alcohol consumption on the risk of hepatocellular carcinoma across different age groups: A nationwide cohort study.

BACKGROUND AND AIMS Alcohol consumption is a well-established risk factor for HCC, though its impact may vary across different age groups. Accordingly, we aimed to investigate the association between alcohol consumption and the risk of HCC across different age groups. METHODS We included 4,234,445 participants aged ≥20 years who underwent a national health examination in 2009. Cox proportional hazards regression models were used to investigate the association of alcohol consumption with the risk of HCC across age groups. RESULTS Among 3,869,084 participants, 20,475 individuals were newly diagnosed with HCC during a median follow-up of 11.3 years. When stratified by 20-year age groups, increasing alcohol consumption was significantly associated with an increased risk of HCC in the ≥60 age group compared to no alcohol consumption (P for trend <0.001). Heavy alcohol consumption was significantly associated with an increased risk of HCC in the 40-59 and ≥60 age groups, with larger effect estimates observed at older ages (aHR, 1.11; 95% CI, 1.05-1.18 for the 40-59 age group; aHR, 1.47; 95% CI, 1.38-1.57 for the ≥60 age group). CONCLUSIONS Our findings indicate that the association between alcohol consumption and the risk of HCC differs across age groups, with the most pronounced risk increase observed among older individuals. These findings may inform age-tailored HCC risk assessment and prevention strategies, particularly by identifying middle-aged and older heavy drinkers who may benefit from more careful risk stratification. IMPACT AND IMPLICATIONS Alcohol consumption is a well-established risk factor for hepatocellular carcinoma (HCC), but its age-specific impact remains insufficiently defined. In this nationwide cohort of 3,869,084 adults, heavy alcohol consumption was associated with increased HCC risk in the 40-59 and ≥60 age groups, with the strongest association and highest 10-year cumulative risk observed among heavy drinkers aged ≥60 years. These findings may help refine age-tailored HCC risk assessment by supporting the consideration of heavy alcohol consumption alongside established liver-related risk factors, particularly in middle-aged and older adults.

Mi Na Kim, Kyungdo Han, Dong Yun Kim et al. · JHEP Reports · 0 citations

Open access Sep 2026

Cumulative Lifestyle Profiles and Osteoporotic Fracture Risk in Older Women: A Nationwide Korean Cohort Study

Background/Objectives: Modifiable lifestyle behaviors may be relevant to osteoporotic fracture risk, but their cumulative association across different levels of skeletal health remains unclear. This study investigated the association between a cumulative lifestyle score and osteoporotic fracture risk according to baseline bone mineral density (BMD) category in older women. Methods: We conducted a nationwide retrospective cohort study using Korean National Health Insurance Service data from 541,770 women aged 66 years who underwent dual-energy X-ray absorptiometry through the national life-transition health screening program between 2010 and 2016. A cumulative lifestyle score ranging from 0 to 3 was constructed by assigning one point each for regular exercise, non- or ex-smoking status, and non-drinking status. Cox proportional hazards models were used to evaluate associations with any, vertebral, hip, and other osteoporotic fractures across normal BMD, osteopenia, and osteoporosis groups. Results: Higher lifestyle scores were generally associated with lower osteoporotic fracture hazards across BMD categories. For any fracture, the adjusted hazard ratios for lifestyle score 3 versus 0 were 0.746 (95% CI, 0.564–0.987) in the normal BMD group, 0.747 (95% CI, 0.630–0.885) in the osteopenia group, and 0.786 (95% CI, 0.668–0.924) in the osteoporosis group. No statistical evidence of interaction between lifestyle score and BMD category was observed. The incidence-rate differences between scores 0 and 3 for any fracture were 4.49, 6.03, and 5.99 per 1000 person-years in the normal BMD, osteopenia, and osteoporosis groups, respectively. Conclusions: A more favorable cumulative lifestyle profile was associated with lower osteoporotic fracture risk across BMD categories in older women. Although there was no statistical evidence that the relative associations differed by BMD category, larger incidence-rate differences were observed among women with lower BMD. These observational findings support the potential value of integrated lifestyle assessment as a complementary component of fracture-risk assessment and counseling.

Dojoon Park, H. Koh, Seokwon Jeong et al. · Healthcare · 0 citations