Which type of cancer is a significant risk associated with chronic hepatitis B infection?

Chronic hepatitis B infection is strongly associated with the development of hepatocellular carcinoma (HCC), making it the correct answer to the question. Hepatitis B virus (HBV) is one of the most well-established risk factors for HCC, particularly in individuals who have chronic infections leading to liver damage and cirrhosis over time. The mechanism involves the integration of viral DNA into the host genome, promoting oncogenic processes such as cellular proliferation and genomic instability.

Hepatocellular carcinoma typically arises in the context of chronic liver inflammation and injury caused by the persistent infection, which can lead to the transformation of hepatocytes into malignant cells. Surveillance for HCC is recommended for individuals with chronic hepatitis B, especially those with additional risk factors like cirrhosis, as early detection can significantly influence management and outcomes.

In contrast, while pancreatic cancer, liver metastases from other primaries, and cholangiocarcinoma are important malignancies, they do not have a direct and specific association with chronic hepatitis B infection like hepatocellular carcinoma does.