A potential link between long-term oral treatment with nucleos(t)ide analogues for chronic hepatitis B virus (HBV) and an increased risk of colorectal (P = .029) and cervical (P = .049) cancers was demonstrated in a presentation at The International Liver Congress.1

Selected patients with chronic HBV receive prolonged treatment with nucleos(t)ide analogues, which are used to prevent the virus from reproducing. Notably, questions have been raised about the long-term safety of such treatments.

“Although our analysis showed that nucleos(t)ide analogue treatment does not increase overall incidence of liver, lung, breast, and urinary/renal malignancies, it did reveal that patients with hepatitis B virus on this treatment had a higher risk of developing colorectal and cervical cancers,” said Professor Grace Wong, MD, Department of Medicine & Therapeutics Academic at the Chinese University of Hong Kong and lead study author. “In light of these findings we strongly urge regular screening of these cancers to help prevent them from developing in patients taking nucleos(t)ide analogue treatment.”

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The research team analyzed data on 45 299 patients with chronic HBV, including 7323 (16.16%) who had undergone nucleos(t)ide analogue treatment. Follow-up continued for up to 7 years.

At the median follow-up of 4.4 years, malignancies occurred in 538 (2.1%) of the untreated patients and 274 (5.7%) patients who had received nucleos(t)ide analogue therapy. Nucleos(t)ide analogue-treated patients had higher risks of developing colorectal cancer (adjusted hazard ratio (aHR) 2.17; 95% confidence interval (Cl) 1.08-4.36; P = .029) and cervical cancer (aHR 4.41; 95% Cl 1.01-19.34; P = .049).

The risk across patients treated versus untreated with nucleos(t)ide analogues was similar for developing other malignancies, including lung and pleural cancers, breast cancer, and renal conditions.

This large-scale study links treatment with nucleos(t)ide analogues and the development of cervical and colorectal cancer, which may change cancer surveillance and management of patients treated for HBV.


1. Wong G. Incidences of all malignancies in patients with chronic hepatitis B receiving long-term oral nucelos(t)ide analogue treatment – a study of 45,299 subjects. Presentation at: The International Liver Congress; April 13 – 17, 2016; Barcelona, Spain. Abstract PS052.