Research Article
Volume 9 Issue 2 - 2022
Risk Assessment of Colorectal Carcinomas in Co-Infected Hepatitis B Patients
E Giray Guven*, Mimi Robertova, Velichka Plamenova Simeonova, Enes Ahmet Guven, Goran Sarafiloski and Margarita Vlahova
Dr. Georgi Stranski University Hospital-Gastroenterology/Pleven Medical University, Bulgaria
*Corresponding Author: E Giray Guven, Dr. Georgi Stranski University Hospital-Gastroenterology/Pleven Medical University, Bulgaria.
Received: October 17, 2021; Published: January 31, 2022




Abstract

Introduction: Colorectal cancers are the third most common cancer with 1.93 million cases and second cause by cancer-related mortality worldwide in 2020 (WHO). The incidence rate follows a slow and steady increasing trend in Eastern Europe in line with the World. Aside from genetic susceptibility, lifestyle, environmental factors and chronic infections and Other lower GI disorders 596 UEG Journal | Abstract Book inflammations are the well-known causes of colorectal cancers. Hepatitis B is the third most common infectious agent that is attributable to cancer risk worldwide by 16.3% [1]. HBS Ag seropositivity is well-linked with hepatocellular carcinomas but the link between HBV and other cancers are not well established.

Aims and Methods: Our aim is to examine the interconnections between HBV infections and colorectal cancers and to assess the degree of the associated risk between them. A selective search strategy was performed to search for relevant original articles using databases in OVID and 7 were selected. The studies selected for analysis varies within etiologies and outcomes and due to dichotomous nature of the events, we used pooled Odds ratio (ORs) in line with confidence intervals using Mantel-Haenszel method. A random-effects model applied for pooled rates to rule out the high heterogeneity according to DerSimion’s study. I2 was calculated to measure the degree of heterogeneity. A bias assessment was made and L’abbe plot was used to assess the strength of the results [3].

Results: Pooled analysis after application of random effects, clearly demonstrated a significant association between colorectal cancers and viral hepatitis of all kinds (OR = 1,29; 95% CI: 1,13 - 1,47, I2 = 74,3% and p = 0,0001) Also calculated, Pearson’s contingency coefficient confirms (0,53) the correlation between HBV co-infection and colorectal carcinoma. If the coefficient lays between 0,5 to 1,0, it is said to be a high degree of correlation with strong probability [2]. 74,3% of I2 may represent substantial heterogeneity in the pooled analysis, thus a publication bias analysis performed and plotted. Results did not demonstrate a great degree of asymmetry that should lead to high bias and Egger’s Bias indicator was consistent with the low bias power of the study [3]. Egger bias = 0,84 (95%CI = 2,7 to 4,4) P = 0,54 Study 1: OR 1,27 95%CI, 1,2 - 1,33 Study 2: OR 1,16 95%CI, 0,71 - 1,89 Study 3: OR 1,60 95%CI, 0,88 - 2,91 Study 4: OR 1,1 95%CI, 1,01 - 1,19 Study 5: OR 1,93 95%CI, 1,46 - 2,55 Study 6: OR 1,96 95%CI, 1,03 - 1,54.

Conclusion: 97,544 co-infected HBV patients out of 910,592 patients were studied. Relative risk analysis and statistics suggested that there may be a strong correlation between HBV and colorectal neoplasia. The risk of developing colorectal neoplasia for HBV patients was 1.7 times higher (RR = 1.70) in comparison with the control groups [4]. There are numerous studies evaluating the association between hepatocellular carcinomas and Hepatitis infections and it is said to increase the risk by 3-fold [7]. However, the number of studies conducted on HBV and colorectal cancers are very limited while Hepatitis is the third most infectious agent that poses an attributable risk to all types of cancers [8]. There are numerous rural areas in Eastern Europe where Hepatitis B infections can be found as high as 6 - 8% [9]. It would be useful to analyze the association with further studies and be able to provide stronger evidence in order to improve the screening rate and standards of colorectal cancers among patients with Hepatitis B infections. Regular fecal immunochemical test (FIT) and colonoscopy may be considered by physicians in co-infected patients. Larger scale studies should be conducted.

Keywords: Colorectal Cancers; Fecal Immunochemical Test (FIT); Colonoscopy; Hepatitis B Patients

References

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  12. Patel BB., et al. “Establishing the link between hepatitis B virus infection and colorectal adenoma”. The Journal of Gastrointestinal Oncology (2015).
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  14. Darvishian M., et al. “Elevated risk of colorectal, liver, and pancreatic cancers among HCV, HBV and/or HIV (co)infected individuals in a population based cohort in Canada”. Therapeutic Advances in Medical Oncology (2021).
Citation: E Giray Guven., et al. “Risk Assessment of Colorectal Carcinomas in Co-Infected Hepatitis B Patients”. EC Gastroenterology and Digestive System 9.2 (2022): 53-60.

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