Tibolone Use Associated With Elevated Hepatocellular Carcinoma Risk: Findings From a Nationwide Cohort
6 affiliations
- 1Department of Biomedical Sciences Seoul National University College of Medicine Seoul South Korea
- 2Chung‐Ang University College of Medicine Seoul South Korea
- 3Department of Medicine CHA University School of Medicine Pocheon South Korea
- 4Department of Biomedical Informatics Korea University College of Medicine Seoul South Korea
- 5Department of Family Medicine Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea Seoul South Korea
- 6Department of Family Medicine Seoul National University Hospital Seoul South Korea
Abstract
Tibolone, a synthetic steroid with estrogenic, progestogenic, and androgenic activity, is widely prescribed for menopausal symptoms, but its association with hepatocellular carcinoma (HCC) remains unclear. Using data from 117,271 women aged ≥ 45 years in the Korean National Health Insurance Service–Health Screening Cohort, we evaluated tibolone use between 2003 and 2007 and identified incident HCC from 2009 through 2019, implementing a 1‐year lag period. Participants were propensity score–matched (1:10) by demographic, lifestyle, and metabolic factors. During a median 11‐year follow‐up, women with ≥ 180 cumulative days of tibolone use showed a higher HCC risk compared with non‐users (hazard ratio [HR], 1.88; 95% CI, 1.07–3.29), which persisted after adjustment for key covariates (adjusted hazard ratio [aHR], 1.74; 95% CI, 0.99–3.06). A dose–response trend was observed (P for trend = 0.043). These findings suggest a possible link between sustained tibolone use and HCC risk, warranting confirmation in larger populations and longer follow‐up, ideally through well‐designed prospective studies.
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BibTeX
@article{lee2026tibolone,
title = {{Tibolone Use Associated With Elevated Hepatocellular Carcinoma Risk: Findings From a Nationwide Cohort}},
author = {Jimin Lee and Hye Jun Kim and Sun Jae Park and Sangwoo Park and Jina Chung and Jiwon Yu and Ju Hyun Kang and Seogsong Jeong and Hyun‐Young Shin and Sang Min Park},
journal = {International Journal of Cancer},
year = {2026},
month = sep,
doi = {10.1002/ijc.70725},
url = {https://doi.org/10.1002/ijc.70725},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Tibolone Use Associated With Elevated Hepatocellular Carcinoma Risk: Findings From a Nationwide Cohort
AU - Jimin Lee
AU - Hye Jun Kim
AU - Sun Jae Park
AU - Sangwoo Park
AU - Jina Chung
AU - Jiwon Yu
AU - Ju Hyun Kang
AU - Seogsong Jeong
AU - Hyun‐Young Shin
AU - Sang Min Park
PY - 2026
DA - 2026/09/01
JO - International Journal of Cancer
DO - 10.1002/ijc.70725
UR - https://doi.org/10.1002/ijc.70725
AB - Tibolone, a synthetic steroid with estrogenic, progestogenic, and androgenic activity, is widely prescribed for menopausal symptoms, but its association with hepatocellular carcinoma (HCC) remains unclear. Using data from 117,271 women aged ≥ 45 years in the Korean National Health Insurance Service–Health Screening Cohort, we evaluated tibolone use between 2003 and 2007 and identified incident HCC from 2009 through 2019, implementing a 1‐year lag period. Participants were propensity score–matched (1:10) by demographic, lifestyle, and metabolic factors. During a median 11‐year follow‐up, women with ≥ 180 cumulative days of tibolone use showed a higher HCC risk compared with non‐users (hazard ratio [HR], 1.88; 95% CI, 1.07–3.29), which persisted after adjustment for key covariates (adjusted hazard ratio [aHR], 1.74; 95% CI, 0.99–3.06). A dose–response trend was observed (P for trend = 0.043). These findings suggest a possible link between sustained tibolone use and HCC risk, warranting confirmation in larger populations and longer follow‐up, ideally through well‐designed prospective studies.
SN - 0020-7136
SN - 1097-0215
ER -