A study from The University of Texas MD Anderson Cancer Center shows the hepatitis C infection, previously linked to liver cancer and non-Hodgkin’s lymphoma, is associated with cancers of the head and neck — a finding that could have immediate implications in how hepatitis-infected patients are screened, and how head and neck cancer patients are treated.
Hepatitis C affects as many as 1.5 percent of the U.S. population, making it the most common blood-borne disease in the country, with an estimated 3.9 million having the chronic infection. This number skyrockets to a whopping 130 million to 150 million when considering the global population. New antivirals with few side effects have, however, made it possible to cure up to 90 percent of all hepatitis C patients.
The study, “Association Between Hepatitis C Virus and Head and Neck Cancers,” was performed at an MD Anderson clinic focusing on the unmet medical needs of patients with hepatitis C. The clinic opened in 2009, and to date remains the only hepatitis-focused clinic among comprehensive cancer centers in the U.S.
“Obviously, a hepatitis C infection could impact how patients respond to their cancer therapy. We also realized that many of our hepatitis patients were excluded from clinical trials. Now that many with hepatitis C can be cured, it is important that we first address and potentially cure the virus, so that they can have access to necessary cancer therapy,” said senior author Harrys A. Torres, in a press release.
The viral infection has long been known to lead to liver cancer, with a risk 48 times higher in hepatitis patients compared to the general population. It has also been associated with a two to three-fold increased risk for non-Hodgkin’s lymphoma. The connection to head and neck cancers has, until now, not been investigated.
“To our surprise, we saw a number of head and neck cancer patients who tested positive for the hepatitis C virus. With this observation, we began to wonder if there was an undiscovered correlation between the two. Our findings tell us that the association between hepatitis C and oropharyngeal and non-oropharyngeal cancers is as high as its link to non-Hodgkin’s lymphoma,” said Torres, who is also an associate professor of Infectious Disease, Infection Control and Employee Health.
The study, published in the Journal of the National Cancer Institute, retrospectively analyzed data on 34,545 patients who had been tested for hepatitis C between 2004 and 2014. Among them were 409 patients with head and neck cancers – 164 with oropharyngeal and 245 with non-oropharyngeal cancer.
Since head and neck cancers are also related to smoking, the research team used another 694 patients suffering smoking-related cancers as a control group. Only 6.5 percent of patients in this group tested positive for hepatitis C.
Patients with head and neck cancers turned out to be much more likely to have a hepatitis infection – 14 percent in patients with oropharyngeal cancer and 20 percent in patients with non-oropharyngeal cancer — compared to only 6.5 percent in the control group.
Expressing it the other way around — a hepatitis C infection increased the risk of various head and neck cancers between 2 and 4.96 times.
Studies of non-Hodgkin’s lymphoma and liver cancer have shown that treating the viral infection might prevent cancer from developing, and even shrink cancers that have already appeared, as recently reported by Lymphoma News Today.
In fact, the National Comprehensive Cancer Network guidelines now recommend clinicians treat the hepatitis first, a recommendation MD Anderson plans to follow.
“What we are trying to make all understand is that this is an infection that has consequences — and it’s an infection we can cure,” Torres said.