In Reply We are thankful for the letters addressing our article.1 The letter from Zhang and Zeng voiced the importance of family history in the risk of hepatocellular carcinoma (HCC). However, family history of a cancer by self-reported data may be prone to recall bias, and its completeness and accuracy are greatly influenced by the patients’ age at the time of the interview and educational level.2 Furthermore, because the majority of patients with chronic hepatitis B in many Asian countries acquire hepatitis B virus (HBV) infection through vertical transmission at the neonatal period, and the risk of HCC progressively increases with increasing age, family history of HCC may be greatly influenced by birth order of the patients among siblings. Considering these potential measurement biases, we included only objective covariates for the analysis of risk factors for HCC in our study.
Choi J, Ko MJ, Lim Y. Lower Risk of Hepatocellular Carcinoma With Tenofovir vs Entecavir in Patients With Chronic Hepatitis B—in Reply. JAMA Oncol. Published online April 25, 20195(6):916–917. doi:10.1001/jamaoncol.2019.0650
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