Decreased incidence of hepatocellular carcinoma in hepatitis B vaccinees: A 20-year follow-up study

Mei-Hwei Chang, San-Lin You, Chien-Jen Chen, Chun-Jen Liu, Chuan-Mo Lee, Shi-Ming Lin, Heng-Cheng Chu, Tzee-Chung Wu, Sheng-Shun Yang, Hsu-Sung Kuo, Ding-Shinn Chen

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490 Citations (Scopus)


Background Hepatitis B virus (HBV) infection is a major cause of hepatocellular carcinoma. This population-based study aimed to investigate whether prevention of hepatocellular carcinoma by the universal Taiwanese HBV vaccine program, launched in July 1984, has extended beyond childhood and to identify the predictors of hepatocellular carcinoma for vaccinated birth cohorts.MethodsData on 1958 patients with hepatocellular carcinoma who were aged 6-29 years at diagnosis in Taiwan between 1983 and 2004 were collected from two national hepatocellular carcinoma registries. Age-and sex-specific incidence among vaccinated and unvaccinated birth cohorts were analyzed by using Poisson regression models. All statistical tests were two-sided. Records of 64 hepatocellular carcinoma patients and 5524435 HBV vaccinees who were born after the initiation of the vaccination program were compared for HBV immunization characteristics during infancy and prenatal maternal hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) serostatus.ResultsHepatocellular carcinoma incidence was statistically significantly lower among children aged 6-19 years in vaccinated compared with unvaccinated birth cohorts (64 hepatocellular cancers among vaccinees in 37709304 person-years vs 444 cancers in unvaccinated subjects in 78496406 person-years, showing an age-and sex-adjusted relative risk of 0.31, P
Original languageEnglish
Pages (from-to)1348-1355
Number of pages8
JournalJournal of the National Cancer Institute
Issue number19
Publication statusPublished - 2009
Externally publishedYes


  • hepatitis B surface antigen
  • hepatitis B vaccine
  • hepatitis B(e) antigen
  • adult
  • article
  • child
  • controlled study
  • female
  • follow up
  • health program
  • hepatitis B
  • human
  • incidence
  • liver cell carcinoma
  • major clinical study
  • male
  • perinatal infection
  • preschool child
  • priority journal
  • risk factor
  • sex difference
  • Taiwan
  • Adolescent
  • Adult
  • Age Distribution
  • Carcinoma, Hepatocellular
  • Child
  • Female
  • Follow-Up Studies
  • Hepatitis B e Antigens
  • Hepatitis B Surface Antigens
  • Hepatitis B Vaccines
  • Humans
  • Incidence
  • Liver Neoplasms
  • Male
  • Mothers
  • Multivariate Analysis
  • Odds Ratio
  • Registries
  • Sex Distribution
  • Young Adult


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