- Volume 14 Issue 11
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Viral Hepatitis and Liver Cancer in Korea: an Epidemiological Perspective
- Yeo, Yohwan (Department of Preventive Medicine, Seoul National University College of Medicine) ;
- Gwack, Jin (Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention) ;
- Kang, Seokin (Soonchunhyang University College of Medicine) ;
- Koo, Boyeon (Seoul National University College of Nursing) ;
- Jung, Sun Jae (Department of Preventive Medicine, Seoul National University College of Medicine) ;
- Dhamala, Prakash (Department of Preventive Medicine, Seoul National University College of Medicine) ;
- Ko, Kwang-Pil (Department of Preventive Medicine, Gachon University of Medicine and Science) ;
- Lim, Young-Khi (Department of Radiological Science, Gachon University College of Health Science) ;
- Yoo, Keun-Young (Department of Preventive Medicine, Seoul National University College of Medicine)
- Published : 2013.11.30
In the past, hepatitis B virus (HBV) infection was endemic in the general Korean population. The association of HBV infection with the occurrence of liver cancer has been well demonstrated in several epidemiologic studies. While the mortality rates of liver cancer in Korea have decreased steadily over the last decade, the presence of hepatitis B surface antigen (HBsAg) in mothers remains high at 3-4%, and 25.5% of these HBsAg positive mothers are positive for hepatitis B e antigen (HBeAg). HBV infection caused almost a quarter of hepatocellular carcinoma (HCC) cases and one-third of deaths from HCC. These aspects of HBV infection prompted the Korean government to create a vaccination program against HBV in the early 1980s. In 1995, the Communicable Disease Prevention Act (CDPA) was reformed, and the government increased the number of HBV vaccines in the National Immunization Program (NIP), driving the vaccination rate up to 95%. In 2000, the National Health Insurance Act (NHIA) was enacted, which provided increased resources for the prevention of perinatal HBV infection. Then in 2002, the Korean government, in conjunction with the Korean Medical Association (KMA), launched an HBV perinatal transmission prevention program. The prevalence of HBsAg in children had been high (4-5%) in the early 1980s, but had dropped to below 1% in 1995, and finally reached 0.2% in 2006 after the NIP had been implemented. After the success of the NIP, Korea finally obtained its first certification of achievement from the Western Pacific Regional Office of the World Health Organization (WPRO-WHO) for reaching its goal for HBV control. An age-period-cohort analysis showed a significant reduction in the liver cancer mortality rate in children and adolescents after the NIP had been implemented. In addition to its vaccination efforts, Korea launched the National Cancer Screening Program (NCSP) for 5 leading sites of cancer, including the liver, in 1999. As a consequence of this program, the 5-year liver cancer survival rate increased from 13.2% (1996-2000) to 23.3% (2003-2008). The development of both the primary and secondary prevention for liver cancer including HBV immunization and cancer screening has been of critical importance.
Hepatitis B;vaccination;screening;liver cancer
- Boyle P, Levin B (2008). Liver Cancer. In 'World Cancer Report 2008'. IARC Press, Lyon pp 350-7.
- Chae HB, Kim JH, Kim JK, Yim HJ (2009). Current status of liver diseases in Korea: hepatitis B. Korean J Hepatol, 15, 13-24. https://doi.org/10.3350/kjhep.2009.15.S6.S13
- Cheon JH, Park JW, Park KW, et al (2004). The clinical report of 1,078 cases of hepatocellular carcinomas: national cancer center experience. Korean J Hepatol, 10, 288-97.
- Cho YK, Song BC (2012). Prevention of viral hepatitis and vaccination. Korean J Med, 82, 123-33 https://doi.org/10.3904/kjm.2012.82.2.123
- Gwack J, Park SK, Lee EH, et al. (2011). Hepatitis B vaccination and liver cancer mortality reduction in Korean children and adolescents. Asian Pac J Cancer Prev, 12, 2205-8.
- Hong SG, Soh JW, Oh JH (1979). Statistical and histological studies on HBsAg in grade-school childrens. J Korean Pediatr Soc, 22, 433-42.
- Jee SH, Ohrr H, Sull JW, Samet JM (2004). Cigarette smoking, alcohol drinking, hepatitis B, and risk for hepatocellular carcinoma in Korea. J Natl Cancer Inst, 96, 1851-6. https://doi.org/10.1093/jnci/djh334
- Jun GH, Kim JJ, Shin DH, Yoon SD (1983). A survey of HBs antigenemia among healthy primary and middle children, pregnant women in Kyungpook province. J Korean Pediatr Soc, 26, 1188-95.
- Jung KW, Won YJ, Kong HJ, et al (2013). Cancer statistics in Korea: incidece, mortality, survival and prevalence in 2010. Cancer Res Treat, 45, 1-14. https://doi.org/10.4143/crt.2013.45.1.1
- Kang YJ, Hong YJ, Kim JH, et al (1996). Pilot study on hepatitis B of 6- to 7-year-old school children in Seoul. Korean J Epidemiol, 18, 151-9.
- Kim CM (2001). Recommendation for liver cancer screening, 2001. Goyang, Korea: Korean National Cancer Center. Seoul, Korea: The Korean Association for the Study of the Liver
- Korea Centers for Disease Control and Prevention (2008). Achievement of hepatitis B control goal in the Republic of Korea.
- Korea Centers for Disease Control and Prevention (2009). Hepatitis B. In 'National statistics for health 2008'. KCDC report, Korea pp 60-1.
- Korea Centers for Disease Control and Prevention (2012). Hepatitis B. In 'National statistics for health 2011'. KCDC report, Korea pp 64-5.
- Korea Centers for Diseases Control and Prevention (2010). National Financial Assistance Program for NIP. Public Health Wkly Rep, 3, 820-3
- Korea Centers for Diseases Control and Prevention (2011). Prevention of perinatal hepatitis B transmission in Korea. Public Health Wkly Rep, 4, 497-9.
- Lee DH, Kim JH, Han BH, et al. (2001). Geographical variation of liver cancer mortality in Korea (1992-1998). Cancer Res Treat, 33, 420-6. https://doi.org/10.4143/crt.2001.33.5.420
- Lim MK, Ju YH, Francesch S, et al (2006). Clonorchis sinensis infection and increasing risk of cholangiocarcinoma in the republic of Korea. Am J Trop Med Hyg, 75, 93-6.
- Ries LAG, Melbert D, Krapcho M, et al (2008). SEER Cancer Statistics Review, 1975-2005, National Cancer Institute. Bethesda, MD.
- Seo DH, Whang DH, Song EY, Kim HS, Park Q (2011). Prevalence of antibodies to hepatitis B core antigen and occult hepatitis B virus infections in Korean blood donors. Transfusion, 51, 1840-6. https://doi.org/10.1111/j.1537-2995.2010.03056.x
- Shin AS, Park S, Shin HR, et al (2011). Population attributable fraction of infection-related cancers in Korea. Ann Oncol, 22, 1435-42. https://doi.org/10.1093/annonc/mdq592
- Shin HR, Lee CE, Park HJ, et al. (1996). Hepatitis B and C virus, Clonorchis sinensis for the risk of liver cancer: a case-control study in Pusan, Korea. Int J Epidemiol, 25, 933-40. https://doi.org/10.1093/ije/25.5.933
- Sim JG, Seo JK, Suh SJ (1995). Prevalence and its changes of hepatitis B viral markers from 1988 to 1993 in Korean children. J Korean Pediatr Soc, 38, 1535-9.
- Yoo KY, Kim H, Lee MS, et al (1991). A reconstructed cohort study on the hepatitis B virus infection as a risk factor of liver cancer in Korea. J Korean Med Sci, 6, 319-24. https://doi.org/10.3346/jkms.1918.104.22.1689
- Yoo KY, Lee MS, Lee Y, et al (1992). A stochastic analysis on the force of infection by hepatitis B virus in Korea. Korean J Epidemiol, 14, 128-37.
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