Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Department of Public Management, The Humanities School, Henan University of Traditional Chinese Medicine, Zhengzhou, People's Republic of China Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK.
Whether hepatitis B virus (HBV) infection increases the risk of pancreatic cancer (PaC) is controversial. We carried out a meta-analysis to evaluate the association between HBV status and the risk of PaC.
PubMed, Embase, and the China National Knowledge Infrastructure were searched from their inception through April 2012 for case-control and cohort studies that have reported an association between HBV status and the risk of PaC. The reference lists of pertinent publications were also reviewed for potential studies. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. A random-effects model was used to summarize odd ratios (ORs) and 95% confidence intervals (CIs).
We included seven case-control studies and three cohort studies, involving 5883 PaC cases. The summary OR of developing PaC was 1.22 (95% CI: 0.90-1.67) for individuals who were HBV surface antigen (HBsAg)-positive. Compared with the individuals who were never exposed to HBV infection, the summary OR of the risk of PaC was 1.60 (95% CI: 1.26-2.05) for chronic or inactive HBsAg carriers (HBsAg-positive) and 1.76 (95% CI: 1.05-2.93) for anti-HBc-positive but anti-HBs-negative individuals.
Inactive HBsAg carrier status and possible occult HBV infection may increase the risk of PaC. Large population-based multicenter prospective studies are required to further confirm this finding.