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Hepatitis B Vaccination as a measure to
prevent hepatocellular carcinoma in Taiwan
Wang CC, Wu MS. National Taiwan University School of Medicine. Taiwan.
Background. Hepatocellular carcinoma (HCC), the fifth most common cause of cancer in
the world,1 is closely associated with hepatitis virus infections. 2 In Taiwan, the carrier rate
of hepatitis B surface antigen (HBsAg) in the general population has been as high as 15%–
20%.3 And HCC has ranked first for cancer mortality in men and second in women in
Taiwan since the early 1980’s.4
Results of nationwide vaccination. Taiwan launched the world’s first nationwide universal
hepatitis B vaccination in 1984 due to the huge disease burden.5 This program reduced the
HBsAg carrier rate in children from ten percent to one percent.6 The incidence of HCC in
children has also declined from 0.52 per 100.000 to 0.13 per 100.000 in children.7
Discussion. Since the incidence of HCC in Taiwan peaks in the sixth decade of life,8 an
overall decrease in the incidence of HCC will probably be noted after 30 to 40 years. This
Taiwanese experience is a good model of preventing cancer with measures to prevent
infectious diseases.
References
1. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating
the world cancer burden: GLOBOCAN 2000. Int J
Cancer. 2001;94:153-156
2. Beasley RP, Hwang LY, Lin CC, Chien CS.
The Effect of Hepatitis B Mass Immunization. The
Journal of Infectious Diseases. 1999;179:367–70
7. Chang MH, Chen CJ, Lai MS, et al. Universal
hepatitis B vaccination in Taiwan and the incidence
Hepatocellular carcinoma and hepatitis B virus: a
of hepatocellular carcinoma in children. Taiwan
prospective study of 22.707 men in Taiwan.
Childhood Hepatoma Study Group. N Engl J Med.
Lancet. 1981;2:1129-33.
1997;336:1855-9.
3. Sung JL, Chen DS, Lai MY, et al. Epidemiological
8. Chen DS. Hepatitis B virus infection, its sequelae,
study on hepatitis B virus infection in Taiwan.
and prevention in Taiwan. In: Okuda K, Ishak KG,
Chin J Gastroenterol. 1984;1:1–9.
eds. Neoplasms of the liver. Tokyo: Springer-
4. Health Statistics. Vital statistics of the Republic of
Verlag. 1987:71-80.
China. Taipei:Department of Health, Executive
Yuan, 2003
5. Chen DS, Hsu NH, Sung JL, et al. A mass
Acknowledgemets
I would like to thank my parents, Wang CP and Chen
vaccination program in Taiwan against hepatitis B
HC, for supporting me; and my teacher Wu MS for
virus infection in infants of hepatitis B surface
supervising my abstract and poster.
antigen-carrier mothers. JAMA. 1987;257:2597603.
6. Hsu HM, Lu CF, Lee SC, et al. Seroepidemiologic
Survey for Hepatitis B Virus Infection in Taiwan:
Summer School Participant
Chia-Chun Wang, Taiwan.
[email protected]