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BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the leading causes of hepatocellular carcinoma worldwide. Mortality related to HCV infection is increasing in Massachusetts and nationally. Treatment of cancer can exacerbate viral hepatitis, leading to increased risk of liver complications. The goal of this project was to determine the frequency and type of cancers, and demographic trends among individuals reported to the Massachusetts Department of Public Health (MDPH) with HBV and/or HCV infection.
METHODS: Between 2002 and 2012, 94,701 cases of HCV and 28,070 cases of HBV infection were reported to the MDPH. These cases were extracted from the Massachusetts Virtual Epidemiologic Network (MAVEN) and matched to the Massachusetts Cancer Registry (MCR) using Link Plus matching software. Trends in cancer diagnosis and demographic information were obtained using SAS 9.3.
RESULTS: Between 2002 and 2012, there were 5,094 (5%) reported HCV infection cases with a cancer diagnosis. Seventy-four percent (n=3,779) were white, non-Hispanic and 13% (n=668) were black, non-Hispanic. Sixty-eight percent (n=3,462) percent were male. The most frequently reported cancers were liver cancer (n=1,187, 23%) and lung cancer (n=577, 11%). The average age at HCV diagnosis was 53.9 years and the average age at cancer diagnosis was 55.7 years.
CONCLUSIONS: Five percent of people with both HCV and HBV infections reported to MDPH were also diagnosed with cancer. Liver cancer was the most frequent cancer among both HCV and HBV cases in Massachusetts. Average age at HBV and HCV diagnosis was similar as was the average age of cancer diagnoses for HCV and HBV cases. Further analyses will include time between HCV or HBV diagnosis and cancer diagnosis, as well as an exploration of HCV and HBV risk factors in association with cancer diagnosis and mortality.