Retrospective population-based cohort study of pancreatic ductal adenocarcinoma risk after hepatitis C infection

A retrospective cohort study, conducted across Veterans Health Administration centers, assessed the assocation between chronic hepatitis C virus (HCV) and pancreatic ductal adenocarcinoma (PDAC). The study included veterans with HCV testing between October 1, 2001, and September 30, 2002, followed-up for at least 18 months after testing. HCV status was categorized as chronic HCV, exposure to HCV, or no HCV. Among 6.3 million individuals tested (92.3% men; median age 61.1 years; IQR 49.9-70.1) , 3.9% had chronic HCV and 3.3% were exposed. Of the 33,451 individuals who developed PDAC, age at diagnosis was younger among those with versus those without HCV (median age 65.0 versus 72.4 years). Compared with no HCV infection, chronic HCV (aHR 1.76; 95% CI 1.67-2.45) and HCV exposure (1.18; 1.11-1.25) were associated with increased risk of incident PDAC. Hazards for PDAC were greater for HCV genotype 3 (aHR 2.02) and genotype 1 (aHR 1.75) than for genotype 2 (aHR 1.35) compared with no HCV infection. The authors conclude that these findings suggest that chronic HCV is a potentially modifiable risk factor for PDAC.