Cancer rates among patients with hepatitis C are increased compared to those not infected

Public Release: 24-Apr-2015

Researchers suggest an extrahepatic manifestation of hepatitis C may be an increased risk of cancer

European Association for the Study of the Liver

April 24, 2015, Vienna , Austria: Results announced today at The International Liver CongressTM 2015 show that cancer rates in patients with the hepatitis C virus (HCV) were significantly increased compared to the non-HCV cohort. The researchers suggest an extrahepatic manifestation of HCV may be an increased risk of cancer.

The aim of the study was to describe the rates of all cancers in the cohort of HCV patients compared to the non-HCV population. Known cancer types associated with hepatitis C include non-Hodgkin's lymphoma, renal and prostate cancers, as well as liver cancer.

A retrospective study at Kaiser Permanente, Southern California, USA, was conducted. The study authors recorded all cancer diagnoses in patients over 18 years of age with or without HCV during 2008-2012. Within the timeframe of the study 145,210 patient years were included in the HCV cohort, and 13,948,826 patient years were included in the non-HCV cohort.

In the HCV cohort there were 2,213 cancer diagnoses (1,524/100,000) during the 5-year period and 1,654 cancer diagnoses when liver cancer was excluded (1,139/100,000). In the non-HCV cohort there were 84,419 cancer diagnoses (605/100,000) during the same 5-year period and 83,795 (601/100,000) when liver cancer was excluded. When all cancers are considered the rate is 2.5 times higher in the HCV cohort; when liver cancers are excluded, the rate is still almost 2 times higher.

Lisa Nyberg, MD, MPH, Kaiser Permanente, Southern California, senior author of the study, explains: "The results suggest that cancer rates are increased in the cohort of hepatitis C patients versus the non-hepatitis C patients, both including and excluding liver cancers. These findings certainly point to the suggestion that hepatitis C may be associated with an increased risk of cancer. However, the findings must be interpreted with caution, as the study also showed that confounding factors such as alcohol abuse, tobacco, obesity, and diabetes modified the results."

Dr Laurent Castera, Vice-Secretary, European Association for the Study of the Liver, commented: "This data adds to the evidence bank linking hepatitis C with an increased risk of cancer, and highlights that there is still a long way to go in order to fully understand this complex and devastating disease."

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INCREASED CANCER RATES IN PATIENTS WITH CHRONIC HEPATITIS C: AN ANALYSIS OF THE CANCER REGISTRY IN A LARGE U.S. HEALTH MAINTENANCE ORGANIZATION

Anders H. Nyberg* 1, Joanie W. Chung2, Jiaxiao M. Shi3, T. C. Cheetham3, Kevin M. Chiang4, Reina Haque5, Zobair M. Younossi6, Lisa M. Nyberg1

1Gastroenterology/Hepatology, Kaiser Permanente, San Diego, 2Kaiser Permanete, Research and Evaluation, 3Research and Evaluation, Kaiser Permanente, Pasadena, 4Pharmacy Analytical Services, Kaiser Permanente, Downey, 5Research and Evaluatuion, Kaiser Permanente, Pasadena, 6Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, United States

Background and Aims: Hepatitis C virus (HCV) is an oncogenic virus, and an increased risk of malignancy in HCV has previously been reported. Cancer types associated with HCV include non-Hodgkin's lymphoma, renal and prostate cancers; as well as liver cancer. The aim of this study was to describe cancer rates in our cohort of HCV patients compared to cancer rates in the non-HCV population.

Methods: This is a retrospective study at Kaiser Permanente Southern California (KPSC), a large health maintenance organization with 3.5-4 million members. The KPSC cancer registry is an accredited program maintaining a complete profile of all cancer diagnoses for all KP members. In this study, we recorded all cancer diagnoses in patients ?18 years of age with or without HCV during 2008-2012.

Results: From 2008 to 2012, 145,210 patient years were included in the HCV cohort, and 13,948,826 patient years were included in the non HCV cohort. Mean age at cancer diagnosis in the HCV cohort was 61.8 years, in the non-HCV cohort, 63.5 years. In the HCV cohort there were 2,213 cancer diagnoses (1524/100000) during the 5 year period and 1,654 cancer diagnoses when liver cancer was excluded (1139/100000). In the non HCV cohort there were 84,419 cancer diagnoses (605/100000) during the same 5 year period and 83,795 (601/100000) when liver cancer was excluded. The rate ratios between the HCV and non HCV cohorts for the total number of cancer cases including and excluding liver cancer are shown in Table 1.

Conclusions: In our cohort of Hepatitis C infected patients, cancer rates were significantly increased compared to the non-HCV cohort. This suggests that another extrahepatic manifestation of HCV may be an increased risk of cancer.

Source