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Association Between Hepatitis B Infection and Pancreatic Cancer: A Population-Based Analysis in the United States

Desai, Rupak, MBBS*; Patel, Upenkumar, MBBS, MPH; Sharma, Shobhit, MBBS, PhD; Singh, Sandeep, MBBS§; Doshi, Shreyans, MD; Shaheen, Sana, MBBS; Shamim, Sofia, MBBS#; Korlapati, Lakshmi Shirisha, MBBS**; Balan, Shuba, MD††; Bray, Christopher, MD, PhD; Williams, Renee, MD, FACG‡‡; Shah, Nihar, MD, FACP§§

doi: 10.1097/MPA.0000000000001095
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Objectives The aim of this study was to assess the role of hepatitis B (HepB) infection in the causation of pancreatic cancer and the predictors of pancreatic cancer and mortality.

Methods We identified pancreatic cancer patients 11 to 70 years of age from the 2013–2014 National Inpatient Sample. Pearson χ2 test and Student’s t-test were used for categorical and continuous variables, respectively. We assessed the association of HepB and pancreatic cancer and the independent mortality predictors by multivariate analyses.

Results Of 69,210 pancreatic cancer patients, 175 patients with a history of HepB and 69,035 patients without a history of HepB were identified. Compared with the pancreatic cancer–non-HepB group, the pancreatic cancer–HepB group consisted more of younger (mean, 60.4 [standard deviation, 7.4] years vs 68.2 [standard deviation, 12.1] years), male, black, and Asian patients with low household income and nonelective admissions. The odds of developing pancreatic cancer among the HepB patients were significantly higher (adjusted odds ratio, 1.24; 95% confidence interval, 1.056–1.449; P = 0.008). Black race, age ≥ 65 years, and male sex demonstrated greater odds of mortality.

Conclusions This study concluded up to a 24% increased likelihood of pancreatic cancer among the HepB patients. Blacks showed greater odds of pancreatic cancer and related mortality.

From the *Research Fellow, Atlanta Veterans Affairs Medical Center, Decatur, GA;

Department of Public Health, National University, San Diego, CA;

Department of Biology, Texas State University, San Marcos, TX;

§Department of Neurology, Institute of Human Behavior and Allied Science, New Delhi, India;

Department of Internal Medicine, University of Central Florida/HCA GME Consortium, North Florida Regional Medical Center, Gainesville, FL;

Department of Internal Medicine, Hurontario Medical Clinic, Mississauga, Ontario, Canada;

#Department of Internal Medicine & Psychiatry, Berkeley Medical & Rehabilitation Center, Atlanta, GA;

**Department of Medicine, Osmania Medical College, Hyderabad, India;

††Department of Internal Medicine, Morehouse School of Medicine, Atlanta, GA;

‡‡Department of Internal Medicine, Gastroenterology, NYU School of Medicine/Bellevue Hospital Center, New York, NY; and

§§Department of Internal Medicine, Gastroenterology, Joan C. Edward School of Medicine, Marshall University, Huntington, WV.

Received for publication January 17, 2018; accepted May 9, 2018.

Address correspondence to: Rupak Desai, MBBS, Atlanta Veterans Affairs Medical Center, 1670 Clairmont Rd, Decatur, GA 30033 (e-mail: drrupakdesai@gmail.com).

The authors declare no conflict of interest.

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