Hepatitis B Patients May Have Increased Risk of Colorectal, Cervical Cancers

Nucleoside analogues did not increase incidence of liver, lung, breast, or urinary or renal malignancies.

Patients with hepatitis B virus (HBV) may have higher risk of developing colorectal and cervical cancers, according to data presented at the 2016 International Liver Congress in Barcelona, Spain.

Nucleoside analogues are recommended for patients with chronic hepatitis B virus, although additional research is required regarding the long-term safety of the treatment.

“Although our analysis showed that nucleoside analogue treatment does not increase overall incidence of liver, lung, breast, and urinary/renal malignancies, it did not reveal that patients with hepatitis B virus on this treatment had a higher risk of developing colorectal and cervical cancers,” lead author Professor Grace Wong, MD, Department of Medicine and Therapeutics Academic at the Chinese University of Hong Kong, explained in a prepared statement.

“In light of these findings we strongly urge regular screening of these cancers to help prevent them from developing in patients taking nucleoside analogue treatment.”

The study included 45 299 patients who had been diagnosed with chronic HBV, 7323 of whom had undergone nucleoside analogue treatment. The primary outcome was any incident malignancies, excluding hepatocellular carcinoma. Researchers followed all participants for up to 7 years, measuring incident malignancies.

After a median follow-up of 4.4 years, researchers observed malignancies in 538 (2.1%) of untreated patients and 274 (5.7%) of patients who received nucleoside analogue therapy. Across treated and non-treated patients, the nucleoside analogue-treated patients had similar risks of developing lung and pleural cancers, breast cancer, and renal cancer.

However, they also found that patients who had nucleoside analogue therapy had a higher risk of developing colorectal cancer (adjusted hazard ratio [HR]: 2.17; 95% confidence interval [CI]: 1.08-4.36; P=.029) and cervical cancer (adjusted HR: 4.41; 95% CI: 1.01-19.34; P=.049).

 “This large-scale study determines an important link between nucleoside analogue treatment and cervical and colorectal cancer,” said Professor Tom Hemming Karlsen, MD, PhD, V ice Secretary of the European Association for the Study of the Liver, in the press release. “The results are important and could change cancer surveillance and management of patients treated for hepatitis B.”


1. Wong G. Abstract PS052. Incidences of all malignancies in patients with chronic hepatitis B receiving long-term oral nucleoside analogue treatment—a study of 35 299 subjects. Presented at the International Liver Congress; April 13-17, 2016; Barcelona, Spain.