Huang C.-F.Lai H.-C.Chen C.-Y.Tseng K.-C.Kuo H.-T.Hung C.-H.Wang J.-H.Chen J.-J.Lee P.-L.Chien R.-N.Yang C.-C.Lo G.-H.Tai C.-M.Lin C.-W.JIA-HORNG KAOCHUN-JEN LIUCHEN-HUA LIUYan S.-L.Bair M.-J.Lin C.-Y.Su W.-W.Chu C.-H.Chen C.-J.Tung S.-Y.Lo C.-C.Cheng P.-N.Chiu Y.-C.Wang C.-C.Cheng J.-S.Tsai W.-L.Lin H.-C.Huang Y.-H.Yeh M.-L.Huang J.-F.Dai C.-Y.Chuang W.-L.Tsai P.-C.Peng C.-Y.Yu M.-L.2021-09-042021-09-0420201572-0241https://www.scopus.com/inward/record.uri?eid=2-s2.0-85089204146&doi=10.14309%2fajg.0000000000000606&partnerID=40&md5=7e3e403455e492d310b13d642baa6777https://scholars.lib.ntu.edu.tw/handle/123456789/581743INTRODUCTION: Chronic hepatitis C virus (HCV) infection is associated with nonhepatocellular carcinoma malignancies. We aimed to evaluate whether achieving a sustained virological response (SVR, defined as HCV RNA seronegativity throughout posttreatment 24-week follow-up) could reduce the risk of non-hepatocellular carcinoma malignancy in a real-world nationwide Taiwanese Chronic Hepatitis C Cohort (T-COACH). METHODS: A total of 10,714 patients with chronic hepatitis C who had received interferon-based therapy (8,186 SVR and 2,528 non-SVR) enrolled in T-COACH and were linked to the National Cancer Registry database for the development of 12 extrahepatic malignancies, including those with potential associations with HCV and with the top-ranking incidence in Taiwan, over a median follow-up period was 3.79 years (range, 0-16.44 years). RESULTS: During the 44,354 person-years of follow-up, 324 (3.02%) patients developed extrahepatic malignancies, without a difference between patients with and without SVR (annual incidence: 0.69% vs 0.87%, respectively). Compared with patients with SVR, patients without SVR had a significantly higher risk of gastric cancer (0.10% vs 0.03% per person-year, P = 0.004) and non-Hodgkin lymphoma (NHL) (0.08% vs 0.03% per person-year, respectively, P = 0.03). When considering death as a competing risk, non-SVR was independently associated with gastric cancer (hazard ratio [HR]/95% confidence intervals [CIs]: 3.29/1.37-7.93, P = 0.008). When patients were stratified by age, the effect of SVR in reducing gastric cancer (HR/CI: 0.30/0.11-0.83) and NHL (HR/CI: 0.28/0.09-0.85) was noted only in patients aged <65 years but not those aged >65 years. DISCUSSION: HCV eradication reduced the risk of gastric cancer and NHL, in particular among younger patients, indicating that patients with chronic hepatitis C should be treated as early as possible.[SDGs]SDG3antivirus agent; age; aged; chronic hepatitis C; cohort analysis; female; human; incidence; male; middle aged; mortality; nonhodgkin lymphoma; register; stomach tumor; survival analysis; sustained virologic response; Taiwan; Age Factors; Aged; Antiviral Agents; Cohort Studies; Female; Hepatitis C, Chronic; Humans; Incidence; Lymphoma, Non-Hodgkin; Male; Middle Aged; Registries; Stomach Neoplasms; Survival Analysis; Sustained Virologic Response; Taiwanjournal article10.14309/ajg.0000000000000606322211622-s2.0-85089204146