Abstract
BackgroundPrevious studies have observed a close association between hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) as well as extrahepatic cancers. However, research concerning the effect of HBV infection on the risk of colorectal cancer (CRC) is rare and inconsistent. This study aims to determine the relationship between HBV infection and new-onset CRC.MethodsWe prospectively examined the relationship between HBV infection and new-onset CRC among 93,390 participants from Kailuan Cohort study. Cox proportional hazards regression models, subgroup analyses and competing risk analyses were used to evaluate the association between HBV infection and the risk of new-onset CRC.ResultsDuring a median follow-up of 11.28 years, 448 incident CRC cases were identified. The adjusted HR (95%confidence interval (CI)) for the association of HBsAg Seropositive with CRC was 1.85(1.15 ~ 2.96) in the Cox regression. Subgroup analyses showed that the HBsAg seropositive group was associated with increased risk of new-onset CRC among male, middle-aged, normal weight, smokers and non-drinker participants, respectively. A positive association of HBV infection with the risk of CRC was observed in the adjusted sub-distribution proportional hazards (SD) models (HRSD = 1.77, 95% CI:1.11–2.84) and cause-specific hazards (CS) models (HRCS = 1.79, 95% CI: 1.13–2.91).ConclusionsOur results have found a significant association between HBV infection and the risk of incident CRC among Chinese participants.Trial registrationKailuan study, ChiCTR–TNRC–11001489. Registered 24 August 2011 - Retrospectively registered, http:// http://www.chictr.org.cn/showprojen.aspx?proj=8050
Highlights
Previous studies have observed a close association between hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) as well as extrahepatic cancers
hepatitis B surface antigen (HBsAg) seropositive group was associated with elevated Alanine aminotransferase (ALT) and Total bilirubin (TBil) concentrations
There was no difference in the prevalence of diabetes mellitus, current drinking, family history of cancer, marital status, high salt diets and the levels of Body mass index (BMI), Waist circumference (WC) and Diastolic blood pressure (DBP) between groups
Summary
Previous studies have observed a close association between hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) as well as extrahepatic cancers. Research concerning the effect of HBV infection on the risk of colorectal cancer (CRC) is rare and inconsistent. WHO estimates that the global prevalence of HBV infection is 3.5%, with approximately 257 million people currently infected [1]. The majority of HBV-infected people were born before the availability of the hepatitis B vaccine [2]. HBV infection is estimated to be responsible for 56% of hepatocellular carcinoma (HCC) [4], which is the main histological type of primary liver cancer. Besides HCC, untreated patients with HBV infection are at an elevated risk for liver fibrosis and liver cirrhosis [5, 6]
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