The association between chronic hepatitis infection and colon cancer: a nationwide case-control study

Chronic hepatitis viral infection (CHI), which is triggered primarily by blood-transmitted infection with hepatitis C virus (HCV) and Hepatitis B virus (HBV), has been reported to link with extra-hepatic cancers, such as, mixed cryoglobulinemia, membrano-proliferative glomerulonephritis, B-cell Non-Hodgkin-Lymphoma types, pancreatic cancer, thyroid gland cancers, cholangiocarcinoma, and leukemia. However, this possible association is still inconclusive. Two epidemiological studies have pointed out the noticeable association between HCV and HBV and colorectal adenoma. With the high prevalence of colon cancer and significant rate of CHI reported in Taiwan, we conducted a nationwide case-control study to explore the association between CHI and colon cancer.
We identified 71,103 subjects with colon cancer, and 71,103 non-colon cancer controls matched for sex, age, who had been randomly selected from the Taiwan National Health Insurance claims data between 2000 and 2011 after excluding participants who were HIV positive, as well as who missed age and gender related information. The multivariate logistic regression was applied to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) to explore the association between colon cancer and CHI. Sex- and age-specific risks of colon cancer for CHI were evaluated.
In our study, subjects with HCV infection had higher risk of colon cancer than their control counterparts (OR = 1.10, 95% CI = 1.02-1.20). HBV infection was found not to be significantly associated with the formation of colon cancer. The odds ratio of colon cancer presence in HBV carriers deceased lightly from 1.11 decreased to 1.04 after adjusted for colon cancer risk factors (95%CI = 0.98-1.11). Stratification by age and sex, young male subjects infected with CHI had more risk of developing colon cancer (OR = 1.25, 95% CI = 1.09-1.44 male HBV carriers aged under 55 years old; OR = 1.31, 95% CI = 1.01-1.70 for male HCV carriers aged 55-64 years old) than their control subjects. However, elder male HBV carriers (≥ 75 years old) had lower risk of having colon cancer (OR = 0.70, 95% CI = 0.58-0.86).
In sum, HCV infection was significantly associated with colon cancer. HBV was associated specifically in men less than 55 years old. This possibly suggests for the potential risk of formation of colon cancer in patients with chronic hepatitis viral infection.