January 20, 2009
Hepatitis C virus (HCV) infection - already known to increase the risk of liver cancer - also increases the risk of intrahepatic cholangiocarcinoma (ICC), or cancer in the bile ducts of the liver, according to a large-scale case-control study of US veterans.
Investigators evaluated 146,394 patients with HCV infection who had two visits to Veterans Affairs health care facilities between 1996 and 2004 and compared them to 572,293 HCV-uninfected patients. Each HCV-infected patient was compared to up to four matched HCV-uninfected patients. Most participants were men who were followed for an average of more than two years.
The risk of liver cancer, or hepatocellular carcinoma, was 15 times greater in those with HCV infection compared to those without HCV infection, a finding that was not unexpected. However, the risk of ICC was 2.55-fold higher in the HCV-infected group. The risk of pancreatic cancer was 23 percent higher in HCV-infected patients, but this association was attenuated after investigators adjusted for alcohol use, pancreatitis, and other variables.
Dr. Hasem B. El-Serag, gastroenterology section chief at the Michael E. DeBakey VA Medical Center in Houston, and colleagues at the National Cancer Institute in Rockville, Md., said the findings linking pancreatic cancer and HCV infection "merit additional investigation."
"From a clinical perspective, early intervention strategies, including screening HCV-positive individuals earlier and more rigorously, may improve the outcomes for both hepatocellular carcinoma and intrahepatic cholangiocarcinoma," the researchers concluded.
The study, "Risk of Hepatobiliary and Pancreatic Cancers After Hepatitis C Virus Infection: A Population-Based Study of US Veterans," was published in Hepatology (2009;49(1):116-123).