HBV tied to increased risk for digestive system cancers

  • Song C & al.
  • JAMA Netw Open
  • 5 Jun 2019

  • International Clinical Digest
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Takeaway

  • HBV infection, commonly associated with hepatocellular carcinoma (HCC), is also a risk factor for extrahepatic cancers, especially those of the digestive system.

Why this matters

  • Findings highlight the importance of HBV treatment and early screening for stomach, colorectal, and pancreatic cancer.

Study design

  • Prospective population-based study with 3 cohorts: China Kadoorie Biobank (CKB, n=496,732); Qidong (n=37,336); and the Changzhou nested case-control study (n=17,723).
  • CKB used a dipstick to detect HBV surface antigen; Qidong and Changzhou used more precise assays.
  • Funding: National Natural Science Foundation of China, National Key Research and Development Program of China.   

Key results

  • CKB cohort: 3.1% HBV+ patients; 20,891 cases of cancer over 4.4 million person-years.
    • HBV was tied to increased risks for HCC (aHR=15.77; P<.001 stomach cancer colorectal pancreatic and lymphoma>
  • Qidong: 9.5% HBV+ patients; 1386 cancer cases over 255,752 person-years.
    • HBV was tied to increased risks for HCC (HR=17.51; P<.001 and stomach cancer>
  • Changzhou cohort validated association between HBV and stomach cancer (OR=1.76; 95% CI, 1.04-2.98).

Limitations

  • Qidong cohort limited by sample size.
  • Low detection rate in CKB cohort may underestimate association strength.