Presentation Authors: Kevin Shee*, Lael Reinstatler, Lebanon, NH, Kristian Stensland, Burlington, MA, John D. Seigne, Einar F. Sverrisson, Lebanon, NH
Introduction: Chronic Hepatitis B (HepB) or Hepatitis C (HepC) infection has been well-established as an important risk factor for the development of hepatocellular carcinoma (HCC). Because HepB/C infection has been directly linked to oncogenesis, in part due to the regulation of p53 activity, it was hypothesized that there may be an association between HepB/C infection and the development of other cancer types, specifically bladder cancer.
Methods: A nationally representative cross-sectional analysis was performed using demographic and clinical data from the National Health and Nutrition Examination Survey (NHANES) database. Data from patients with any bladder cancer diagnosis over a four-year period were obtained, and positivity for Hepatitis B Surface Antibody (HBAbS), Hepatitis B Core Antibody (HBAbC), and Hepatitis C Antibody (HCAb) were analyzed as risk factors using logistic regression analyses controlling for age, smoking status, race, and BMI.
Results: From the NHANES database, 447,694 bladder cancer cases and 287,300,485 controls were included in the study. Cases tended to be significantly older than controls (71.8 vs 48.0 years old, p < 0.0001), and were more likely to be Caucasian (94.7% vs 63.3%, p < 0.0001). HBAbS, HBAbC, and HCAb were not significantly different between the two groups. On logistic regression, HBAbs was found to be significantly enriched in bladder cancer cases vs controls (OR=10.4, p < 0.0001). HBAbc (OR=0.240, p=0.216) and HCAb (OR=1.52, p=0.732) were not significantly different between groups.
Conclusions: In this study using a large, nationally representative database, HBAbs, which is a marker of HepB serology, was found to be significantly associated with a diagnosis of bladder cancer. To our knowledge, this is the first study to report a significant relationship between HepB and bladder cancer. These findings warrant validation in additional cohorts and investigation into the specific pathophysiologic mechanisms of increased bladder cancer risk.