A 65-Year-Old Man Comes to the Office Due to Progressive

A 65-year-old man comes to the office due to progressive weight loss, jaundice, and anorexia over the last 3 months.  His urine has been dark and his stools have been pale.  The patient has no prior medical conditions and takes no medications.  He has smoked a pack of cigarettes a day for 40 years.  He drinks 2 cups of coffee every day and 1 or 2 glasses of wine on most nights.  He used illicit drugs for 2 years when he was in his teens but has used none since.  The patient has a sedentary lifestyle and frequently consumes red and processed meats.  Vital signs are within normal limits.  BMI is 28 kg/m².  Physical examination shows scleral icterus.  The chest is clear to auscultation and percussion.  Abdominal examination shows an enlarged but nontender gallbladder.  There is no ascites.  Which of the following is the strongest factor predisposing to this patient's current condition?

A) Alcohol use
B) Cigarette smoking
C) Coffee consumption
D) Low-fiber diet
E) Processed meat consumption
F) Viral hepatitis

Correct Answer:

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