Hepatic Cysts in Korea: Prevalence, Incidence, and Risk Factors Based on a 5.8-Year Follow-up Health Screening Cohort.

BACKGROUND

Hepatic cysts are fluid-filled liver lesions that are mostly asymptomatic, but fewer than 15% of patients present clinically significant symptoms. Reported prevalence ranges from 2.5% to 71%, yet prior studies have been limited by small populations and incomplete assessment of risk factors. This study aimed to determine the prevalence, incidence, and risk factors using data from a large health screening cohort in Korea.

METHODS

We performed a retrospective cohort analysis of 78,676 participants in the Health and Prevention Enhancement cohort who underwent abdominal ultrasound at the Seoul National University Hospital Healthcare System Gangnam Center from 2003 and 2014. Hepatic cysts were identified using a validated rule-based text-mining algorithm applied to ultrasound reports. Prevalence was estimated from baseline data. Incidence was assessed in 41,179 participants initially negative for hepatic cysts. Risk factors were determined through Cox proportional hazards modeling.

RESULTS

The prevalence of hepatic cysts at baseline was 8.54% (95% confidence interval [95% CI], 8.34-8.73). The incidence was 23.4 per 1,000 person-years at risk (95% CI, 22.8-24.0). Cox regression identified hepatitis B virus surface antigen (HBs-Ag) positivity (hazard ratio [HR], 1.20; 95% CI, 1.00-1.45) and renal cyst presence (HR, 1.46; 95% CI, 1.31-1.64) as independent risk factors, whereas diabetes mellitus (HR, 0.64; 95% CI, 0.54-0.77) and high physical activity (HR, 0.89; 95% CI, 0.81-0.97) appeared protective.

CONCLUSION

This study provides the prevalence of 8.54%, incidence, and risk factors of hepatic cysts. Renal cyst presence and HBs-Ag positivity are significant risk factors, whereas high physical activity and diabetic status are protective.