HBV Infection Associated With Digestive System Cancers

Computer illustration of a malignant (cancerous) tumour (red) in the colon. Risk factors for colorectal cancer are smoking, obesity and lack of physical activity.
In China, researchers found data that showed that patients with HBsAg seropositive test results were at an increased risk of developing hepatocellular carcinoma, stomach cancer, oral cancer, colorectal cancer, pancreatic cancer, and lymphoma.

Infection with hepatitis B virus (HBV) is associated with the risk for nonliver cancer, particularly digestive system cancers, according to a study published in JAMA Network Open.1

HBV is one of the most serious and prevalent health conditions in the world, and the cause of up to 80% of cases of hepatocellular carcinoma, particularly in Chinese and African populations.2,3 A few clinical case studies have detected HBV in several types of nonliver tissues, suggesting that HBV may play a role in the oncogenesis of nonliver cancers.4-6 However, few population-based studies have observed associations between chronic HBV infection and various nonliver cancers7-11; therefore, researchers assessed the associations between chronic HBV infection and risk for all cancer types in a population-based study involving 496,732 Chinese individuals.1 They found that hepatitis B surface antigen (HBsAg) seropositivity (n=15,355) was associated with the risk for hepatocellular carcinoma (hazard ratio [HR], 15.77; 95% CI, 14.15-17.57), stomach cancer (HR, 1.41; 95% CI, 1.11-1.80), colorectal cancer (HR, 1.42; 95% CI, 1.12-1.81), oral cavity cancer (HR, 1.58; 95% CI, 1.01-2.49), pancreatic cancer (HR, 1.65; 95% CI, 1.03-2.65), and lymphoma (HR, 2.10; 95% CI, 1.34-3.31) compared with patients who were HBsAg seronegative (n=481,377). These associations were further validated in independent population- and tissue-based studies.

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The authors concluded that, “In a large prospective Chinese cohort of 496 732 adults, we found that participants who were HBsAg seropositive were at an increased risk of developing [hepatocellular carcinoma] and several nonliver cancers, including stomach cancer, oral cancer, colorectal cancer, pancreatic cancer, and lymphoma.”1

1. Song C, Lv J, Liu Y, et al. Associations between hepatitis B virus infection and risk of all cancer types. JAMA Network Open. 2019;2(6):e195718.

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9. Andersen ES, Omland LH, Jepsen P, et al; DANVIR Cohort Study. Risk of all-type cancer, hepatocellular carcinoma, non-Hodgkin lymphoma and pancreatic cancer in patients infected with hepatitis B virus. J Viral Hepat. 2015;22(10):828-834.

10. Sundquist K, Sundquist J, Ji J. Risk of hepatocellular carcinoma and cancers at other sites among patients diagnosed with chronic hepatitis B virus infection in Sweden. J Med Virol. 2014;86(1):18-22.

11. Kamiza AB, Su FH, Wang WC, Sung FC, Chang SN, Yeh CC. Chronic hepatitis infection is associated with extrahepatic cancer development: a nationwide population-based study in Taiwan. BMC Cancer. 2016;16(1):861.