Hepatitis C Virus Infection Associated with Oral Potentially Malignant Disorder, Oral Cancer, and Liver Diseases: A Community-Based Cross-Sectional Study

Donlagon Jumparway¹, Chen-Yang Hsu^{2

3

4}, Amy Ming-Fang Yen⁵, Ting-Yu Lin⁶, Saman Warnakulasuriya⁷, Tony Hsiu-Hsi Chen⁶, Dih-Ling Luh^{8

9}, Chiu-Wen Su¹⁰, Pongdech Sarakarn¹¹, Yen-Po Yeh^{12

13

14}, Sam Li-Sheng Chen⁵

Affiliations

¹ School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
² Department of Internal Medicine, Daichung Hospital, Miaoli 350, Taiwan.
³ Taiwan Association of Medical Screening, Taipei 103, Taiwan.
⁴ Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
⁵ School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
⁶ Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
⁷ Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London WC2R 2LS, UK.
⁸ Department of Public Health, Chung Shan Medical University, Taichung 402306, Taiwan.
⁹ Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung 402306, Taiwan.
¹⁰ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100229, Taiwan.
¹¹ Faculty of Public Health, Khon Kaen University, Khon Kaen 40002, Thailand.
¹² Changhua County Public Health Bureau, Changhua 500009, Taiwan.
¹³ Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100229, Taiwan.
¹⁴ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10031, Taiwan.

PMID: 41301060
PMCID: PMC12650934
DOI: 10.3390/cancers17223695

Hepatitis C Virus Infection Associated with Oral Potentially Malignant Disorder, Oral Cancer, and Liver Diseases: A Community-Based Cross-Sectional Study

Donlagon Jumparway et al. Cancers (Basel). 2025.

. 2025 Nov 18;17(22):3695.

doi: 10.3390/cancers17223695.

Authors

Affiliations

¹ School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
² Department of Internal Medicine, Daichung Hospital, Miaoli 350, Taiwan.
³ Taiwan Association of Medical Screening, Taipei 103, Taiwan.
⁴ Master of Public Health Degree Program, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
⁵ School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
⁶ Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
⁷ Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London WC2R 2LS, UK.
⁸ Department of Public Health, Chung Shan Medical University, Taichung 402306, Taiwan.
⁹ Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung 402306, Taiwan.
¹⁰ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei 100229, Taiwan.
¹¹ Faculty of Public Health, Khon Kaen University, Khon Kaen 40002, Thailand.
¹² Changhua County Public Health Bureau, Changhua 500009, Taiwan.
¹³ Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100229, Taiwan.
¹⁴ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10031, Taiwan.

PMID: 41301060
PMCID: PMC12650934
DOI: 10.3390/cancers17223695

Abstract

Background/Objectives: While smoking, areca nut chewing, and alcohol are established risk factors, Hepatitis C virus (HCV) infection has emerged as a potential risk for oral neoplasia. This study explores any association of HCV infection with oral potentially malignant disorder (OPMD) and oral cancer, following adjustment for HCV-related liver disease in a large screening cohort. Methods: Data from 37,720 participants in the Changhua Community-Based Integrated Screening Program (2005-2014) with smoking or areca nut use history were analyzed. OPMD and cirrhosis were identified at screening, while oral and liver cancers were diagnosed during follow-up. Information on demographics, lifestyle, and clinical factors, including chronic and active HCV infection, was collected. Multinomial logistic regression was used to assess associations between HCV status and disease outcomes. Results: The prevalence of hepatitis C viremia was higher in the OPMD group (4.4%) and oral cancer group (3.3%) compared to the screen-negative group (2.7%), and highest in the cirrhosis/liver cancer group (23.3%). The odds ratios of OPMD and oral cancer were 1.59 (95% CI: 1.20-2.01) and 1.22 (95% CI: 0.67-2.23), respectively, in subjects with hepatitis C viremia compared to those without. After adjusting for confounding factors, individuals with hepatitis C viremia were at increased risk of OPMD by 50% (aOR = 1.50; 95% CI: 1.17-1.92) but not a statistically significant elevated risk for oral cancer (aOR = 1.09; 95% CI: 0.59-2.01), which was possibly attenuated due to HCV-related liver disease (aOR = 11.59; 95% CI: 8.33-16.13). Conclusions: HCV infection may act as an early risk factor for OPMD, though its progression to oral cancer may occur alongside the risk of HCV-related liver diseases. Including HCV status in screening may aid early detection and secondary prevention of oral cancer in high-risk groups.

Keywords: HCV-related liver diseases; hepatitis C viremia; oral cancer; oral potentially malignant disorder; risk factor.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**Figure 1**
Flowchart Representing Data Collection in the Changhua Community-based Integrated Screening (CHCIS) Program.

**Figure 2**
Adjusted odds ratios for factors associated with OPMD and oral cancer.

**Figure 3**
The Relationship of Risk Factors, Disease Progress, and Outcomes.

See this image and copyright information in PMC

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Hepatitis C Virus Infection Associated with Oral Potentially Malignant Disorder, Oral Cancer, and Liver Diseases: A Community-Based Cross-Sectional Study

Affiliations

Hepatitis C Virus Infection Associated with Oral Potentially Malignant Disorder, Oral Cancer, and Liver Diseases: A Community-Based Cross-Sectional Study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources