For professionals:

• Hepatocellular carcinoma is the most common primary hepatic cancer.
• Hepatocellular carcinoma is one of the ten most common carcinoma in the world.
• Hepatocellular carcinoma is most common in Southeast Asia, the western pacific region, and sub-Saharan Africa.
• In Taiwan, where the malignancy is the first cause of death among the ten most common cause of death, the hepatocellular carcinoma is the most common cause of death due to malignancy in males.
• Hepatocellular carcinoma is closely related to HBV and HCV infection.
• Epidemiological data highly indicated that there is a consistent and specific causal association between HBV infection and occurrence of HCC.
• Persistent HBV infection is considered to be an essential factor in the development of HCC.
  Therefore, the vertical transmission in the perinatal infection from carrier mothers or after the infection in early life become the important causal factor.
• In Taiwan, the nation-wide vaccination against HBV, which has been enforced on all newborn babies since July 1984, showed an effective results,
  -- the mass vaccination is a successful method to the control of HBV infection in an endemic area.
  • Serum samples of 1515 children below the age of 12 years were enrolled in this study.
  • The overall prevalence rate of serum HBsAg significantly decreased from 9.8 % in 1984 to 1.3 % in 1994.
  • The overall anti-HBc was 26 % in 1984, 15 % in 1989, and 4.0 % in 1994.
  • Seroepidemiology of hepatitis B virus infection in children: Ten years of mass vaccination in Taiwan. Chen, H-L, Chang, M-H et al: ( JAMA 276; 906-908, 1996)
  • Hepatitis B vaccination and hepatocellular carcinoma rates in boys and girls. Chang MH, Shau WY, Chen CJ and et al. (JAMA 2000 Dec 20;284(23):3040-2)
• In Taiwan,
  • 80 ~ 85 % of the HCC cases are associated with HBV infection and half of the remaining cases are associated with HCV infection,
  • thus around 95 % of HCC cases are related to HBV and/or HCV infections
• In Japan,
  • 75 ~ 80 % of HCC are associated with HCV infection,
  • 10 ~ 20 % are associaated with HBV infection,
  • 3 ~ 4 % associated with alcohol abuse.

Prevention of HCC by vaccination against HBV:

• Evidence that HBV vaccination reduce the average annual incidence of hepatocellular carcinoma in children 6 to 14 years of age declined from 0.70 per 100,000 children between 1981 and 1986 to 0.57 between 1986 and 1990, and to 0.36 between 1990 and 1994 ( P<0.01).
• The corresponding rates of mortality from hepatocellular carcinoma also decreased. The incidence of hepatocellular carcinoma in children 6 to 9 years of age declined from 0.52 for those born between 1974 and 1984 to 0.13 for those born between 1984 and 1986 (P<0.001), after universal vaccination started in 1984 in Taiwan (Chang, M.H.; NEJM 1997; 386: 1855 ~ 1859; June 26, 1997)