Hepatitis B virus infection and the risk of cancer among the Chinese population |
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Authors: | Ting Tian Ci Song Longfeng Jiang Jingjing Dai Yuan Lin Xin Xu Chengxiao Yu Zijun Ge Yuqing Ding Yang Wen Bo Liu Yuyun Shao Ping Shi Chuanlong Zhu Yuan Liu Shenqi Jing Zhongmin Wang Zhibin Hu Jun Li |
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Affiliation: | 1. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China;2. Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China;3. Department of Infectious Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China;4. Office of Infection Management, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China;5. Information Department, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China |
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Abstract: | The relationship between hepatitis B virus (HBV) and nonhepatocellular cancers remains inconclusive. This large case-control study aimed to assess the associations between HBV infection status and multiple cancers. Cases (n = 50 392) and controls (n = 11 361) were consecutively recruited from 2008 to 2016 at the First Affiliated Hospital of Nanjing Medical University. Multivariable adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression by adjusting age and gender. A meta-analysis based on published studies was also performed to verify the associations. Of these, 12.1% of cases and 5.5% of controls were hepatitis B surface antigen (HBsAg) seropositive. We observed significant associations between HBsAg seropositivity and esophagus cancer (aOR [95% CI] = 1.32 [1.13-1.54]), stomach cancer (1.46 [1.30-1.65]), hepatocellular carcinoma (HCC; 39.11 [35.08-43.59]), intrahepatic and extrahepatic bile duct carcinoma (ICC and ECC; 3.83 [2.58-5.67] and 1.72 [1.28-2.31]), pancreatic cancer (PaC; 1.37 [1.13-1.65]), non-Hodgkin lymphoma (NHL; 1.88 [1.61-2.20]) and leukemia (11.48 [4.05-32.56]). Additionally, compared to participants with HBsAg−/anti-HBs−/anti-HBc−, participants with HBsAg−/anti-HBs−/anti-HBc+, indicating past HBV-infected, had an increased risk of esophagus cancer (aOR [95% CI] = 1.46 [1.24-1.73]), stomach cancer (1.20 [1.04-1.39]), HCC (4.80 [3.95-5.84]) and leukemia (15.62 [2.05-119.17]). Then the overall meta-analysis also verified that HBsAg seropositivity was significantly associated with stomach cancer (OR [95% CI] = 1.23 [1.14-1.33]), ICC (4.05 [2.78-5.90]), ECC (1.73 [1.30-2.30]), PaC (1.26 [1.09-1.46]), NHL (1.95 [1.55-2.44]) and leukemia (1.54 [1.26-1.88]). In conclusion, both our case-control study and meta-analysis confirmed the significant association of HBsAg seropositivity with stomach cancer, ICC, ECC, PaC, NHL and leukemia. Of note, our findings also suggested that the risk of stomach cancer elevated for people whoever exposed to HBV. |
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Keywords: | cancer case-control study hepatitis B virus meta-analysis |
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