Chronic hepatitis infection is associated with extrahepatic cancer development: a nationwide population-based study in Taiwan

Abram Bunya Kamiza; Fu-Hsiung Su; Wen-Chang Wang; Fung-Chang Sung; Shih-Ni Chang; Chih-Ching Yeh

doi:10.1186/s12885-016-2918-5

Chronic hepatitis infection is associated with extrahepatic cancer development: a nationwide population-based study in Taiwan

BMC Cancer. 2016 Nov 8;16(1):861. doi: 10.1186/s12885-016-2918-5.

Authors

Abram Bunya Kamiza¹, Fu-Hsiung Su^{2

3

4

5}, Wen-Chang Wang⁶, Fung-Chang Sung^{7

8}, Shih-Ni Chang^{7

8}, Chih-Ching Yeh^{9

10}

Affiliations

¹ School of Public Health, College of Public Health and Nutrition, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
² Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
³ Department of Family Medicine, Taipei Medical University Hospital, No. 252 Wu-Hsing Street, Taipei, 11031, Taiwan.
⁴ Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
⁵ School of Medicine, Flinders University, Bedford Park, Australia.
⁶ The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
⁷ Management Office for Health Data, China Medical University Hospital, No. 2 Yude Road, Taichung, 40402, Taiwan.
⁸ Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
⁹ School of Public Health, College of Public Health and Nutrition, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan. ccyeh@tmu.edu.tw.
¹⁰ Department of Public Health, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan. ccyeh@tmu.edu.tw.

Abstract

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the major causes of chronic hepatitis infection (CHI). This longitudinal cohort study investigated the association of CHI with hepatic and extrahepatic cancer development in Taiwan.

Methods: Patients with HBV infection and HCV infection were identified from the Taiwan National Health Insurance Research Database. A Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for determining the association between CHI and cancer development.

Results: The patients with HBV infection exhibited an increased risk of colorectal cancer (HR: 1.36, 95 % CI: 1.09-1.70), liver cancer (HR: 21.47, 95 % CI: 18.0-25.6), gallbladder and extrahepatic bile duct cancer (HR: 2.05, 95 % CI: 1.07-3.91), pancreatic cancer (HR: 2.61, 95 % CI: 1.47-4.61), kidney cancer (HR: 1.72, 95 % CI: 1.10-2.68), ovarian cancer (HR: 2.31, 95 % CI: 1.21-4.39), and non-Hodgkin's lymphoma (HR: 2.10, 95 % CI: 1.25-3.52). The patients with HCV infection exhibited an increased risk of liver cancer (HR: 25.10, 95 % CI: 20.9-30.2), gallbladder and extrahepatic bile duct cancer (HR: 2.60, 95 % CI: 1.42-4.73), ovarian cancer (HR: 5.15, 95 % CI: 1.98-13.4), and non-Hodgkin's lymphoma (HR: 2.30, 95 % CI: 1.34-3.96).

Conclusion: The present population-based study revealed that in addition to its association with primary liver cancer, CHI is associated with an increased risk of extrahepatic cancer.

Keywords: Cancer risk; Hepatitis B virus; Hepatitis C virus; Taiwan.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Biomarkers
Chronic Disease
Coinfection
Comorbidity
Female
Hepatitis B, Chronic / complications
Hepatitis C / complications
Hepatitis, Viral, Human / complications*
Hepatitis, Viral, Human / virology
Humans
Incidence
Liver Neoplasms / etiology
Male
Middle Aged
Neoplasms / diagnosis
Neoplasms / epidemiology*
Neoplasms / etiology*
Population Surveillance*
Proportional Hazards Models
Taiwan / epidemiology

Substances

Biomarkers