Association between chronic viral hepatitis infection and breast cancer risk: a nationwide population-based case-control study

Fu-Hsiung Su, Shih-Ni Chang, Pei-Chun Chen, Fung-Chang Sung, Chien-Tien Su, Chih-Ching Yeh, Fu-Hsiung Su, Shih-Ni Chang, Pei-Chun Chen, Fung-Chang Sung, Chien-Tien Su, Chih-Ching Yeh

Abstract

Background: In Taiwan, there is a high incidence of breast cancer and a high prevalence of viral hepatitis. In this case-control study, we used a population-based insurance dataset to evaluate whether breast cancer in women is associated with chronic viral hepatitis infection.

Methods: From the claims data, we identified 1,958 patients with newly diagnosed breast cancer during the period 2000-2008. A randomly selected, age-matched cohort of 7,832 subjects without cancer was selected for comparison. Multivariable logistic regression models were constructed to calculate odds ratios of breast cancer associated with viral hepatitis after adjustment for age, residential area, occupation, urbanization, and income. The age-specific (<50 years and ≥50 years) risk of breast cancer was also evaluated.

Results: There were no significant differences in the prevalence of hepatitis C virus (HCV) infection, hepatitis B virus (HBV), or the prevalence of combined HBC/HBV infection between breast cancer patients and control subjects (p = 0.48). Multivariable logistic regression analysis, however, revealed that age <50 years was associated with a 2-fold greater risk of developing breast cancer (OR = 2.03, 95% CI = 1.23-3.34).

Conclusions: HCV infection, but not HBV infection, appears to be associated with early onset risk of breast cancer in areas endemic for HCV and HBV. This finding needs to be replicated in further studies.

References

    1. Hortobagyi GN, de la Garza Salazar J, Pritchard K, Amadori D, Haidinger R, Hudis CA, Khaled H, Liu MC, Martin M, Namer M. et al.The global breast cancer burden: variations in epidemiology and survival. Clin Breast Cancer. 2005;11(5):391–401. doi: 10.3816/CBC.2005.n.043.
    1. Leong SP, Shen ZZ, Liu TJ, Agarwal G, Tajima T, Paik NS, Sandelin K, Derossis A, Cody H, Foulkes WD. Is breast cancer the same disease in Asian and Western countries? World J Surg. 2010;11(10):2308–2324. doi: 10.1007/s00268-010-0683-1.
    1. Pollan M. Epidemiology of breast cancer in young women. Breast Cancer Res Treat. 2010;11(Suppl 1):3–6.
    1. Huang CS, Lin CH, Lu YS, Shen CY. Unique features of breast cancer in Asian women--breast cancer in Taiwan as an example. J Steroid Biochem Mol Biol. 2010;11(4-5):300–303. doi: 10.1016/j.jsbmb.2009.12.017.
    1. Lim SE, Back M, Quek E, Iau P, Putti T, Wong JE. Clinical observations from a breast cancer registry in Asian women. World J Surg. 2007;11(7):1387–1392. doi: 10.1007/s00268-007-9086-3.
    1. Casey PM, Cerhan JR, Pruthi S. Oral contraceptive use and risk of breast cancer. Mayo Clinic proceedings Mayo Clinic. 2008;11(1):86–90. quiz 90-81.
    1. Hamilton R, Williams JK, Bowers BJ, Calzone K. Life trajectories, genetic testing, and risk reduction decisions in 18-39 year old women at risk for hereditary breast and ovarian cancer. Journal of genetic counseling. 2009;11(2):147–159. doi: 10.1007/s10897-008-9200-1.
    1. Lajous M, Boutron-Ruault MC, Fabre A, Clavel-Chapelon F, Romieu I. Carbohydrate intake, glycemic index, glycemic load, and risk of postmenopausal breast cancer in a prospective study of French women. The American journal of clinical nutrition. 2008;11(5):1384–1391.
    1. Terry KL, Willett WC, Rich-Edwards JW, Michels KB. A prospective study of infertility due to ovulatory disorders, ovulation induction, and incidence of breast cancer. Archives of internal medicine. 2006;11(22):2484–2489. doi: 10.1001/archinte.166.22.2484.
    1. Richardson A. Is breast cancer caused by late exposure to a common virus? Med Hypotheses. 1997;11(6):491–497. doi: 10.1016/S0306-9877(97)90118-3.
    1. Zur Hausen H. The search for infectious causes of human cancers: where and why. Virology. 2009;11(1):1–10. doi: 10.1016/j.virol.2009.06.001.
    1. de Villiers EM, Sandstrom RE, zur Hausen H, Buck CE. Presence of papillomavirus sequences in condylomatous lesions of the mamillae and in invasive carcinoma of the breast. Breast Cancer Res: BCR. 2005;11(1):R1–11.
    1. Glaser SL, Hsu JL, Gulley ML. Epstein-Barr virus and breast cancer: state of the evidence for viral carcinogenesis. Cancer Epidemiol Biomarkers Prev. 2004;11(5):688–697.
    1. Yasui Y, Potter JD, Stanford JL, Rossing MA, Winget MD, Bronner M, Daling J. Breast cancer risk and "delayed" primary Epstein-Barr virus infection. Cancer Epidemiol Biomarkers Prev. 2001;11(1):9–16.
    1. Mazouni C, Fina F, Romain S, Ouafik L, Bonnier P, Brandone JM, Martin PM. Epstein-Barr virus as a marker of biological aggressiveness in breast cancer. Br J Cancer. 2011;11(2):332–337. doi: 10.1038/sj.bjc.6606048.
    1. Giordano TP, Henderson L, Landgren O, Chiao EY, Kramer JR, El-Serag H, Engels EA. Risk of non-Hodgkin lymphoma and lymphoproliferative precursor diseases in US veterans with hepatitis C virus. JAMA. 2007;11(18):2010–2017. doi: 10.1001/jama.297.18.2010.
    1. Omland LH, Farkas DK, Jepsen P, Obel N, Pedersen L. Hepatitis C virus infection and risk of cancer: a population-based cohort study. Clin Epidemiol. 2010;11:179–186.
    1. Iloeje UH, Yang HI, Jen CL, Su J, Wang LY, You SL, Lu SN, Chen CJ. Risk of pancreatic cancer in chronic hepatitis B virus infection: data from the REVEAL-HBV cohort study. Liver Int. 2010;11(3):423–429. doi: 10.1111/j.1478-3231.2009.02147.x.
    1. Engels EA, Cho ER, Jee SH. Hepatitis B virus infection and risk of non-Hodgkin lymphoma in South Korea: a cohort study. Lancet Oncol. 2010;11(9):827–834. doi: 10.1016/S1470-2045(10)70167-4.
    1. Fwu CW, Chien YC, You SL, Nelson KE, Kirk GD, Kuo HS, Feinleib M, Chen CJ. Hepatitis B virus infection and risk of intrahepatic cholangiocarcinoma and non-Hodgkin lymphoma: a cohort study of parous women in Taiwan. Hepatology. 2011;11(4):1217–1225. doi: 10.1002/hep.24150.
    1. Chang KJ, Kuo WH, Wang MY. The epidemiology of breast cancer inTaiwan. J Chinese Oncol Soc. 2008;11(2):85–93.
    1. Tsai MC, Kee KM, Chen YD, Lin LC, Tsai LS, Chen HH, Lu SN. Excess mortality of hepatocellular carcinoma and morbidity of liver cirrhosis and hepatitis in HCV-endemic areas in an HBV-endemic country: geographic variations among 502 villages in southern Taiwan. J Gastroenterol Hepatol. 2007;11(1):92–98. doi: 10.1111/j.1440-1746.2006.04489.x.
    1. Lu JF, Hsiao WC. Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Aff (Millwood) 2003;11(3):77–88. doi: 10.1377/hlthaff.22.3.77.
    1. Liang SH, Chen TJ, Lee SS, Tseng FC, Huang CK, Lai CH, Chiou CP, Wang JL, Chung HC, Lin JN. et al.Risk factors of isolated antibody against core antigen of hepatitis B virus: association with HIV infection and age but not hepatitis C virus infection. J Acquir Immune Defic Syndr. 2010;11(2):122–128.
    1. Anderson WF, Matsuno R. Breast cancer heterogeneity: a mixture of at least two main types? J Natl Cancer Inst. 2006;11(14):948–951. doi: 10.1093/jnci/djj295.
    1. Agarwal G, Pradeep PV, Aggarwal V, Yip CH, Cheung PS. Spectrum of breast cancer in Asian women. World J Surg. 2007;11(5):1031–1040. doi: 10.1007/s00268-005-0585-9.
    1. Kuo WH, Yen AM, Lee PH, Hou MF, Chen SC, Chen KM, Chen TH, Chang KJ. Incidence and risk factors associated with bilateral breast cancer in area with early age diagnosis but low incidence of primary breast cancer: analysis of 10-year longitudinal cohort in Taiwan. Breast Cancer Res Treat. 2006;11(2):221–228. doi: 10.1007/s10549-006-9194-z.
    1. Richardson AK, Cox B, McCredie MR, Dite GS, Chang JH, Gertig DM, Southey MC, Giles GG, Hopper JL. Cytomegalovirus, Epstein-Barr virus and risk of breast cancer before age 40 years: a case-control study. Br J Cancer. 2004;11(11):2149–2152.
    1. Wang T, Chang P, Wang L, Yao Q, Guo W, Chen J, Yan T, Cao C. The role of human papillomavirus infection in breast cancer. Med Oncol. 2011.
    1. Malaguarnera M, Gargante MP, Risino C, Ranno S, Berretta M, Cannizzaro MA, Costanzo M, Fricia T, Rampello E, Romano M. Hepatitis C virus in elderly cancer patients. European journal of internal medicine. 2006;11(5):325–329. doi: 10.1016/j.ejim.2006.02.004.
    1. Larrey D, Bozonnat MC, Kain I, Pageaux GP, Assenat E. Is chronic hepatitis C virus infection a risk factor for breast cancer? World J Gastroenterol. 2010;11(29):3687–3691. doi: 10.3748/wjg.v16.i29.3687.
    1. Bruno G, Andreozzi P, Graf U, Santangelo G. Hepatitis C virus: a high risk factor for a second primary malignancy besides hepatocellular carcinoma. Fact or fiction? Clin Ter. 1999;11(6):413–418.
    1. Perz JF, Armstrong GL, Farrington LA, Hutin YJ, Bell BP. The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. J Hepatol. 2006;11(4):529–538. doi: 10.1016/j.jhep.2006.05.013.
    1. Cacoub P, Fabiani FL, Musset L, Perrin M, Frangeul L, Leger JM, Huraux JM, Piette JC, Godeau P. Mixed cryoglobulinemia and hepatitis C virus. Am J Med. 1994;11(2):124–132. doi: 10.1016/0002-9343(94)90132-5.
    1. Neri S, Ierna D, Mauceri B, Abate G, Cilio D, Bordonaro F, Calvagno S, Balsamo D, Pulvirenti D, Magliocco O. et al.Can ultrasonographic findings of perihepatic lymphadenopathy promote investigations to detect possible presence of virus C infection in non-symptomatic subjects? Hepatol Res. 2003;11(2):124–128. doi: 10.1016/S1386-6346(03)00198-0.
    1. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepatitis C virus infection. Lancet Infect Dis. 2005;11(9):558–567. doi: 10.1016/S1473-3099(05)70216-4.
    1. Gumber SC, Chopra S. Hepatitis C: a multifaceted disease. Review of extrahepatic manifestations. Ann Intern Med. 1995;11(8):615–620.
    1. Zignego AL, Ferri C, Pileri SA, Caini P, Bianchi FB. Extrahepatic manifestations of Hepatitis C Virus infection: a general overview and guidelines for a clinical approach. Dig Liver Dis. 2007;11(1):2–17. doi: 10.1016/j.dld.2006.06.008.
    1. Hadziyannis SJ. Nonhepatic manifestations and combined diseases in HCV infection. Dig Dis Sci. 1996;11(12 Suppl):63S–74S.
    1. Agnello V, De Rosa FG. Extrahepatic disease manifestations of HCV infection: some current issues. J Hepatol. 2004;11(2):341–352. doi: 10.1016/j.jhep.2003.10.009.

Source: PubMed

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