Changing risk factors for hepatocellular carcinoma in hyperendemic regions in the era of universal hepatitis B vaccination
| Autor: | Hui-Hua Jia, Tim J. Harrison, Jin-Mei Huang, Zhong-Liao Fang, Hua-Bing Liu, Xue-Yan Wang, Xue-Ming Lu |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Cancer Research Pediatrics medicine.medical_specialty China Carcinoma Hepatocellular Adolescent Epidemiology medicine.disease_cause 03 medical and health sciences symbols.namesake Young Adult 0302 clinical medicine Risk Factors medicine Humans 030212 general & internal medicine Poisson regression Risk factor Young adult Child Hepatitis B virus business.industry Liver Neoplasms Vaccination Infant Newborn Infant Middle Aged medicine.disease Hepatitis B digestive system diseases Oncology Immunization Hepatitis b vaccination 030220 oncology & carcinogenesis Hepatocellular carcinoma Child Preschool symbols Female business |
| Zdroj: | Cancer epidemiology. 67 |
| ISSN: | 1877-783X |
| Popis: | Background LongAn, Guangxi, was the first county in China to implement universal childhood hepatitis B virus (HBV) immunization. We aimed to determine its long-term effects in preventing hepatocellular carcinoma (HCC) 32 years after the immunization programme was launched. Methods Information on HCC deaths for LongAn and its neighbouring county, BinYang (where universal hepatitis B vaccination was not started till 2002), were obtained from the national mortality surveillance system. The data were analysed using Poisson regression. Results The overall age-adjusted mortalities of HCC in LongAn and BinYang during 2017–2018 were 53.3/100,000 and 45.4/100,000, respectively. The mortality of males aged 20–29 years in LongAn, who were vaccinated at birth, was lower (2.7/100,000, 95%CI 0.8–4.5) than that of males in BinYang, who were not vaccinated (4.7/100,000, 95%CI 3.2–6.3). In LongAn, the HCC mortality in adults aged 20–29 years declined significantly from 7.9/100,000 (95%CI 4.4–11.4) in 2004 to 1.4/100,000 (95%CI 0.4–2.4) in 2017–2018 (χ2 = 5.554, p = 0.018). Among those vaccinated at birth, the HCC mortality in mountainous areas, where dietary exposure to aflatoxins is more common, is higher (9.0/100,000, 95%CI 4.5–13.5) than in low-lying areas (6.5/100,000, 95%CI 3.6–9.4) (χ2 = 0.2393, p = 0.618). Conclusion Immunization of infants against HBV has reduced their risk of developing HCC as children and young adults but could not prevent all cases of HCC, suggesting that the major risk factor for HCC in hyperendemic regions is shifting from HBV to other factors. Additional prevention strategies for HCC will be needed in the future. |
| Databáze: | OpenAIRE |
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