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Dose‐response association between hepatitis B surface antigen levels and liver cancer risk in Chinese men and women
Author(s) -
Yang Yang,
Gao Jing,
Li HongLan,
Zheng Wei,
Yang Gong,
Zhang Wei,
Ma Xiao,
Tan YuTing,
Rothman Nathaniel,
Gao YuTang,
Chow WongHo,
Shu XiaoOu,
Xiang YongBing
Publication year - 2016
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.30086
Subject(s) - hbsag , medicine , odds ratio , liver cancer , confidence interval , confounding , case control study , hepatitis b , cancer antigen , cancer , population , gastroenterology , hepatitis b virus , immunology , environmental health , virus
We aimed at evaluating the risk of liver cancer in different levels of HBsAg among Chinese men and women. We carried out a nested case‐control study including 363 cases and 3,511 controls in two population‐based cohorts in Shanghai. Plasma samples collected at enrollment were quantified for HBsAg levels using the Architect QT assay. Conditional logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for liver cancer, with adjustment for potential confounders. HBsAg was detected in 6.29% of control subjects overall (7.02% in men and 4.98% in women). HBsAg levels were positively associated with liver cancer risk in a dose‐response manner ( p trend < 0.001). Such association showed a significant gender disparity. With increasing levels of HBsAg, liver cancer risks rose more steeply in men than in women. In men, the adjusted ORs increased from 7.27 (95% CI: 3.49–15.15) at the lowest detectable level of HBsAg (5–9 IU/ml) to 7.16 (95% CI: 3.21–15.96), 34.30 (95% CI: 16.94–69.44), and 47.33 (95% CI: 23.50–95.34) at the highest level of HBsAg (≥1,000 IU/ml) compared to those negative for HBsAg. The corresponding ORs were much lower for women, from 1.37 (95% CI: 0.25–7.47), 3.81 (95% CI: 1.09–13.28), 7.36 (95% CI: 2.41–22.46) and 16.86 (95% CI: 7.24–39.27), respectively. HBsAg quantification has potential to distinguish individuals at different risks of liver cancer. Men with the lowest detectable level of HBsAg should still pay attention to their liver cancer risks, but those with a higher level may be given a higher priority in future liver cancer surveillance program.