{
  "abstract": "Introduction The association between occupational exposures and hepatocellular carcinoma (HCC) has not been well-established. Chemicals used in pesticides and fertilizers have been suggested to increase the risk of HCC by causing oxidative damage. Agricultural workers, a prominent sector in Egypt, are at a greater risk of exposure. We aim to explore the role of occupational risk factors in the development of HCC among cirrhotic patients in Egypt.Methods This case-control study was conducted at Alexandria Main University Hospital. Data collection took place between February and December 2025 by trained personnel using pre-designed questionnaires. Controls included cirrhotic patients who achieved negative viremia (HCV or HBV) for at least two years. Cases included patients with HCC on top of cirrhosis who have achieved negative viremia for at least two years. Analysis was conducted using Jamovi software.Results The mean age of HCC cases was higher than cirrhotic controls (64.5 ± 10.0 vs 60.8 ± 10.9 years). Males predominated among HCC cases (61.3%), whereas controls showed a slight female predominance (53.5%). Rural residence, low monthly income (<3000 EGP), and married status were similarly distributed in both groups. HCV was the predominant cause of cirrhosis among HCC cases (93.5%), while controls had more heterogeneous etiologies, including HCV (40.2%) and MASLD (33.3%). Agriculture was the most common occupation in both groups, accounting for 38.7% of HCC cases and 35.6% of controls.In this preliminary case–control analysis, rural residence showed an increase in the odds of HCC compared with cirrhotic controls (OR: 1.12; 95% CI: 0.49–2.53). Farming as a primary occupation was associated with a slight increase in HCC odds (OR: 1.02; 95% CI: 0.45–2.35), while employment in an industrial setting was not (OR: 0.61; 95% CI: 0.21–1.77). Smoking and a positive family history increased the odds of HCC (OR: 1.46; 95% CI: 0.46–4.67 and OR: 1.23; 95% CI: 0.45–3.36, respectively).Conclusion While limited by sample size and preliminary power, these findings suggest that occupational and socioeconomic risk factors may play a role in HCC development among cirrhotic patients after sustained viral clearance. Using cirrhotic patients without HCC as controls rather than general ­population comparators intentionally minimized the ­dominant ­carcinogenic effects of active HCV or HBV and cirrhosis-­related disease progression, allowing a more isolated evaluation of non-viral, occupational and socioeconomic exposures. Larger studies are warranted to explore HCC risk factors in Egypt’s post HCV elimination era.",
  "authors": [
    {
      "affiliations": [
        "Faculty of Medicine, Alexandria University, Alexandria, Egypt"
      ],
      "name": "Malak A Hassan"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Alexandria University, Alexandria, Egypt"
      ],
      "name": "Mohamed Mahmoud Marey"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Alexandria University, Alexandria, Egypt"
      ],
      "name": "Nada Mohamed Faragallah"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Alexandria University, Alexandria, Egypt"
      ],
      "name": "Mariam H Ghallab"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Alexandria University, Alexandria, Egypt"
      ],
      "name": "Rana Saleh Sharaf"
    },
    {
      "affiliations": [
        "Faculty of Medicine, Alexandria University, Alexandria, Egypt"
      ],
      "name": "Mohamed Mohamed Belal"
    },
    {
      "affiliations": [
        "Department of Hepatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt"
      ],
      "name": "Ahmed Kamal"
    }
  ],
  "title": "P121 Association between occupational exposure and hepatocellular carcinoma risk in Egypt: a preliminary case–control analysis",
  "uid": "26d29fe1-b2b2-5bc6-8243-cbbfa7592f8f"
}