BACKGROUND: Several studies have proposed an association between hepatitis B and pancreatic cancer. Although the spectrum of serological tests varied between studies, hepatitis B virus (HBV) surface antigen (HBsAg) test results were consistently reported. This meta-analysis evaluates the association between HBsAg positivity and pancreatic cancer.
METHODS: A systematic literature search was performed from inception through September 2013 for English language studies using the following terms: "hepatitis B," "HBsAg," "pancreatic cancer," and "pancreatic adenocarcinoma." Studies that have not reported cumulative odds ratio for the association of interest were excluded. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CI) were calculated using a random-effects model. Statistical heterogeneity and publication bias were addressed using the I2 statistic and Egger's weighted regression statistics, respectively.
RESULTS: We included two case-control studies and one cohort study, involving 1,636 patients with pancreatic cancer. The OR of developing pancreatic cancer was 1.50 (95% CI 1.21 to 1.87) for individuals who were HBsAg-positive. The type of study, case-control versus cohort, did not appear to influence the results. Only two of the three studies reported the association between anti-HBc positivity and pancreatic cancer. Our analysis revealed a nonsignificant increased risk of cancer in patients with positive anti-HBc status (OR 1.23, 95% CI 0.95-1.59). No statistically significant heterogeneity or publication bias was noted.
CONCLUSION: HBsAg positivity is associated with an increased risk of pancreatic cancer. Additional studies are needed to clearly define the association between chronic hepatitis B infection and pancreatic cancer. This could have important implications for both primary prevention and treatment of pancreatic cancer.
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