Posted online September 29, 2008, on www.jco.org .
A new study has shown that evidence of hepatitis B infection was twice as common in people with pancreatic cancer than in healthy controls. This study is the first to report an association between past exposure to the hepatitis B virus and pancreatic cancer, but researchers cautioned that more studies are necessary to evaluate the nature of the link.
The investigators compared evidence of hepatitis B and C infection (as determined by blood tests assessing antibodies to these viruses) between 476 patients with pancreatic cancer and 879 healthy individuals. Evidence of past exposure to hepatitis B was found in 7.6 percent of patients versus 3.2 percent of controls. People with both diabetes (an established risk factor for pancreatic cancer) and hepatitis B exposure had a 7-fold increase in pancreatic cancer risk, compared to controls. No association was found between hepatitis C exposure and pancreatic cancer.
The researchers also found that there may be an increased risk of liver failure after chemotherapy treatment among patients with pancreatic cancer who have a history of hepatitis B infection.
About Pancreatic Cancer and Hepatitis B
Pancreatic cancer is estimated to strike 37,680 people in the U.S. in 2008, and 34,290 people die from the disease. Because it is usually diagnosed in its advanced stages by the time patients experience symptoms, it is very difficult to cure. Smoking and diabetes raise the risk of pancreatic cancer, but the disease also develops in people without these risk factors.
Two million people in the U.S. are currently living with chronic hepatitis B infection. While most new cases in previously healthy adults are cleared by the immune
system within a few months, many people - especially those infected as newborns and children - develop chronic, lifelong infections.
What This Means for Patients
If these findings are confirmed and hepatitis B is identified as a risk factor for pancreatic cancer, people with hepatitis B infection may need to be aware that they have an increased risk of this cancer and they may want to reduce their exposure to other risk factors, such as smoking. It is also important that people who have tested positive for hepatitis B at any point in their life share this health history with their physicians, so that appropriate monitoring of potential pancreatic cancer symptoms can be provided.
Patients with pancreatic cancer who have a history of exposure to hepatitis B may have an increased risk of liver failure after chemotherapy. If these findings are confirmed, oncologists may want to consider checking the hepatitis B status of their patients with pancreatic cancer before beginning chemotherapy.