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



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.



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).



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.
School of Public Health, College of Public Health and Nutrition, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
Abram Bunya
AB
Kamiza
Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.|Department of Family Medicine, Taipei Medical University Hospital, No. 252 Wu-Hsing Street, Taipei, 11031, Taiwan.|Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.|School of Medicine, Flinders University, Bedford Park, Australia.
Fu-Hsiung
FH
Su
The Ph.D. Program for Translational Medicine, College of Medical Science and Technology, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
Wen-Chang
WC
Wang
Management Office for Health Data, China Medical University Hospital, No. 2 Yude Road, Taichung, 40402, Taiwan.|Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
Fung-Chang
FC
Sung
Management Office for Health Data, China Medical University Hospital, No. 2 Yude Road, Taichung, 40402, Taiwan.|Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan.
Shih-Ni
SN
Chang
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.|Department of Public Health, China Medical University, No. 91 Hsueh-Shih Road, Taichung, 40402, Taiwan. ccyeh@tmu.edu.tw.
Chih-Ching
CC
Yeh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002908:Chronic Disease; D060085:Coinfection; D015897:Comorbidity; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000821:virology; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011159:Population Surveillance; D016016:Proportional Hazards Models; D013624:Taiwan / Q000453:epidemiology
D015415:Biomarkers
Cancer risk; Hepatitis B virus; Hepatitis C virus; Taiwan