title: Is previous exposure to hepatitis B a risk factor for pancreatic cancer or hepatocellular carcinoma?
abstract: OBJECTIVE
  We evaluated whether prior infection with the hepatitis B virus (HBV) influences the development of pancreatic cancer or hepatocellular carcinoma (HCC).
  
  
  BACKGROUND
  Prior infection with HBV may predispose patients to developing pancreatic cancer or HCC.
  
  
  METHODS
  We conducted a retrospective cohort study using administrative data from an integrated health care system. We identified all patients who had HBV testing over a 13-year period. These patients were divided into 1 of 3 cohorts based on HBV status: negative infection (n=28,719), previous exposure (n=5141), or active infection (n=404). Pancreatic cancer and HCC data were obtained from pathology reports in the health system's cancer registry.
  
  
  RESULTS
  In a multivariable model, age [hazards ratio (HR), 1.08; confidence interval (CI), 1.06-1.09; P<0.001)] and presence of diabetes (HR, 1.88; CI, 1.27-2.80; P=0.002) were identified to have significant influence on pancreatic cancer development, whereas previous HBV exposure did not have a significant influence (HR, 1.41; CI, 0.88-2.27; P=0.16). In a separate multivariable model, male sex (HR, 2.05; CI, 1.35-3.11; P<0.001), age (HR, 1.08; CI, 1.06-1.09; P<0.001), being hepatitis C positive (HR, 5.40; CI, 3.51-8.33; P<0.001), and presence of cirrhosis (HR, 27.84; CI, 17.43-44.46, P<0.001) were all significant predictors of HCC. However, previous HBV exposure was not associated with HCC development (HR, 1.03; CI, 0.68-1.56; P=0.88).
  
  
  CONCLUSIONS
  Data from this study indicate that previous HBV exposure is not a risk factor for the development of either pancreatic cancer or HCC.
authors.affiliation: *Department of Internal Medicine, Division of Gastroenterology-Hepatology †Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, Detroit, MI.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Tang
authors.forename: Rishi
authors.initials: R
authors.lastname: Sharma
authors.forename: Lois
authors.initials: L
authors.lastname: Lamerato
authors.forename: Michael
authors.initials: M
authors.lastname: Sheehan
authors.forename: Richard
authors.initials: R
authors.lastname: Krajenta
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Gordon
mesh_terms: D000367:Age Factors; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000821:virology*; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000821:virology*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors