IN1 THE INCREASED RISKS OF NON-HEPATIC CANCERS AMONG HEPATITIS C VIRUS (HCV) INFECTED PATIENTS: A POPULATION-BASED COHORT STUDY IN THE U.S.

Abstract

There is conflicting evidence whether hepatitis C virus (HCV) increases the risk of non-hepatic cancers. This study aims to examine the association between chronic HCV infection and the risk of developing non-hepatic cancers in the U.S. We conducted a retrospective cohort study using Truven MarketScan Database (January 2005 - December 2016). Our HCV cohort included adult cancer-free patients with newly diagnosed chronic HCV infection. The index date was defined as the first HCV diagnosis date. The non-HCV cohort included cancer-free patients without HCV, 1:5 matched with the HCV cohort based on age, sex and index date. The study outcomes were incident non-Hodgkin lymphoma (NHL) and cancers of the lung, colorectum, head and neck, esophagus, pancreas, prostate, and breast. Patients were followed from the index date to the end of enrollment or incident cancer event. Cox proportional hazards models with inverse probability of treatment weighting were employed to estimate hazard ratios (HRs) with 95% confidence intervals (CIs), adjusting for baseline demographics, comorbidities, and cancer-related medication use. We identified 62,078 HCV patients and 193,167 non-HCV patients, with a median follow-up of 3.5 years. HCV infection was associated with a higher risk of NHL (HR = 1.95, 95% CI = 1.57-2.42), and cancers of the lung (HR = 1.35, 95% CI = 1.20-1.51), colorectum (HR = 1.19, 95% CI = 1.05-1.35), head and neck (HR = 1.57, 95% CI = 1.33-1.84), esophagus (HR = 1.48, 95% CI = 1.11-1.98), and pancreas (HR = 1. 79, 95% CI = 1.48-2.17). HCV infection was negatively associated with breast cancer (HR = 0.87, 95% CI = 0.77-0.97), but unrelated to prostate cancer (HR = 0.99, 95% CI = 0.91-1.07). In the real world, chronic HCV infection was associated with an increased risk of developing NHL, lung, head and neck, esophagus, and pancreatic cancers.