Hepatitis B virus infection and the risk of cancer among the Chinese population. Issue 11 (16th July 2020)

• Record Type: Journal Article
• Authors: Tian, Ting; Song, Ci; Jiang, Longfeng; Dai, Jingjing; Lin, Yuan; Xu, Xin; Yu, Chengxiao; Ge, Zijun; Ding, Yuqing; Wen, Yang; Liu, Bo; Shao, Yuyun; Shi, Ping; Zhu, Chuanlong; Liu, Yuan; Jing, Shenqi; Wang, Zhongmin; Hu, Zhibin; Li, Jun
• Is Part Of: International journal of cancer. Volume 147:Issue 11(2020)
• Page Start: 3075
• Page End: 3084
• Publication Date: 2020-07-16
• Subjects: cancer -- case‐control study -- hepatitis B virus -- meta‐analysis; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.33130
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: The relationship between hepatitis B virus (HBV) and nonhepatocellular cancers remains inconclusive. This large case‐control study aimed to assess the associations between HBV infection status and multiple cancers. Cases (n = 50 392) and controls (n = 11 361) were consecutively recruited from 2008 to 2016 at the First Affiliated Hospital of Nanjing Medical University. Multivariable adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression by adjusting age and gender. A meta‐analysis based on published studies was also performed to verify the associations. Of these, 12.1% of cases and 5.5% of controls were hepatitis B surface antigen (HBsAg) seropositive. We observed significant associations between HBsAg seropositivity and esophagus cancer (aOR [95% CI] = 1.32 [1.13‐1.54]), stomach cancer (1.46 [1.30‐1.65]), hepatocellular carcinoma (HCC; 39.11 [35.08‐43.59]), intrahepatic and extrahepatic bile duct carcinoma (ICC and ECC; 3.83 [2.58‐5.67] and 1.72 [1.28‐2.31]), pancreatic cancer (PaC; 1.37 [1.13‐1.65]), non‐Hodgkin lymphoma (NHL; 1.88 [1.61‐2.20]) and leukemia (11.48 [4.05‐32.56]). Additionally, compared to participants with HBsAg−/anti‐HBs−/anti‐HBc−, participants with HBsAg−/anti‐HBs−/anti‐HBc+, indicating past HBV‐infected, had an increased risk of esophagus cancer (aOR [95% CI] = 1.46 [1.24‐1.73]), stomach cancer (1.20 [1.04‐1.39]), HCC (4.80 [3.95‐5.84]) and leukemia (15.62 [2.05‐119.17]). Then the overall meta‐analysis also verified that HBsAg seropositivity was significantly associated with stomach cancer (OR [95% CI] = 1.23 [1.14‐1.33]), ICC (4.05 [2.78‐5.90]), ECC (1.73 [1.30‐2.30]), PaC (1.26 [1.09‐1.46]), NHL (1.95 [1.55‐2.44]) and leukemia (1.54 [1.26‐1.88]). In conclusion, both our case‐control study and meta‐analysis confirmed the significant association of HBsAg seropositivity with stomach cancer, ICC, ECC, PaC, NHL and leukemia. Of note, our findings also suggested that the risk of stomach cancer elevated for people whoever exposed to HBV. What's new?: Infection with hepatitis B virus (HBV) is an important cause of hepatocelluar carcinoma and may be linked to certain non‐hepatocellular cancers as well, including colon cancer and stomach cancer. This case‐control investigation of cancer patients in China shows that positivity for hepatitis B surface antigen (HBsAg) is significantly higher in cancer patients overall than in controls. Among Chinese patients, HBsAg seropositivity was associated particularly with stomach cancer, pancreatic cancer, intrahepatic and extrahepatic bile duct carcinoma, non‐Hodgkin lymphoma, and leukemia. These observations were consistent with meta‐analysis of previous studies exploring possible associations between HBV and non‐hepatocellular cancers.