Purpose: To examine excessive alcohol consumption and obesity as risk factors for epithelioid hemangioendothelioma (EHE) of the liver, lungs, and bones. Methods: The nine tenets of the Bradford Hill criteria of epidemiological causation served as the conceptual framework of this study. Documented cases of EHE of the liver, lungs, and bones were collected from the International Hemangioendothelioma Epithelioid and Related Vascular Disorders registry database. A secondary data analysis was conducted using the Behavioral Risk Factor Surveillance System telephone survey. US census data were employed to obtain regional demographic data that were used as covariate controls for the study. Correlation and regression analyses were conducted to examine relationships among the rates of regional obesity, alcohol consumption, and prevalence of EHE of the liver, lungs, and bones. Results: Obesity proved to be a significant predictor of EHE of the liver, lungs, and bones; excessive alcohol consumption was not a significant predictor. Income was found to be a statistically significant covariate. Conclusions: The results highlight the need for research further examining the link between obesity and EHE. Knowledge of potential risk factors may facilitate greater understanding of this rare cancer and the development of improved protocols to expand EHE screening and documentation.

epithelioid hemangioendothelioma, obesity, alcohol consumption