Hepatitis C Virus (HCV) Infection and Pancreatic Adenocarcinoma (PAC): A Review

Abstract

Introduction: Chronic hepatitis C infection has been found to be associated with increased cancer risks including hepatocellular cancers and lymphomas. This is a systemic review of literature on the association of chronic hepatitis C virus infection (HCV) with Pancreatic Adenocarcinoma (PAC). Methods: Pubmed search of the articles on the association of HCV and PAC.Table 1: Case-control studies for association of chronic HCV infection with pancreatic cancer.Table 2: Cohort studies for association of chronic HCV infection with pancreatic cancer.Results: Three case control studies have looked into the association of HCV and PAC [1-3]. In Woo S et al., anti HCV seropositivity was found to be associated with increased risk of developing pancreatic cancer [1]. In Chang M et al., HCV infection was not found to be associated with risk of developing pancreatic cancer after adjusting for age, sex, DM and smoking [2]. In Hassan M et al., HCV was not found to be associated with increased risk of pancreatic cancer [3]. Seven cohort studies have looked into the association of HCV and PAC [4-10]. HCV was not found to be associated with increased risk of pancreatic cancer as compared to individuals without a positive infection marker in Abe S et al [4]. Also, Huang J et al. noted that HCV slightly increase the risk of pancreatic cancer as compared to general population [6]. In El-Serag H et al., HCV associated risk of pancreatic cancer was slightly elevated, which was attenuated after adjusting for alcohol use, pancreatitis, cholelithiasis or choledocholithiasis, HBV, or primary sclerosing cholangitis [6]. Increased risk of PAC was also noticed among HCV infected patients in Omland L et al. and Allison R et al [5, 7]. Duberg A et al. noticed increased risk of death from pancreatic cancer in HCV cohort [10]. However, Amin J et al. did not show increased incidence of PAC in HCV diagnosed patients [9]. Conclusion: Three case control studies and seven cohort studies have been conducted to look into the association of HCV with pancreatic cancer [1-3]. Only one case control study done in Korea showed increased risk of PAC in HCV positive subjects [1]. The other case control studies of adequate sample size did not confirm this association [2, 3]. Similarly, conflicting results were found among the cohort studies conducted in different countries [4-10]. However, more focused cohort studies have also not shown a positive association between HCV and pancreatic cancer after adjusting for risk factors like pancreatitis and alcohol use [6]. Based on current data, increase pancreatic cancer screening among HCV infected patients is not clearly indicated.