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Design

• US administrative claim database, Jan 2006-Mar 2017, HCV adults with no prior cancer
  • 10 989 exposed to IFN before May 2011, follow-up to Nov 2013
  • 22 894 exposed to DAA starting Dec 2013, follow-up to Mar 2017
• Outcome: cancer
• Absolute rates (95% CI) of cancer per 100 person-years
• Adjusted hazard ratios estimating cancer risk associated with DAA compared with IFN
  • Cox proportional hazards adjusting for baseline covariates
  • Weighting based on treatment propensity scores

Baseline characteristics

Risk of cancers

No significant difference for other major cancers (colorectal, breast (female), esophageal, pancreatic)

* Adjusted for age, sex, drug abuse, acohol abuse, smoking, cirrhosis/fibrosis, anemia, overweight/obesity, coronary atheroscleosis , HBV infection, mental illness, alcoholic liver damage, portage hypertension, ESLD, thrombocytopenia, and use of chemotherapy, immunomodulators and aspirin

Conclusions

• DAA exposure was associated with a lower risk of cancer relative to IFN exposure
  • For total non-hepatic cancers
  • For leukemia, prostate, bladder and lung cancers
• Hypothesis
  • May reflect the long-term impact of improved SVR with DAA at a population level