world cancer report - iarc

HEPATITIS B VACCINATION
SUMMARY
> Persons chronically infected with hepatitis
B virus are at high risk of developing
chronic liver disease (cirrhosis) and
hepatocellular carcinoma.
> The likelihood of infection is greatest for
infants and decreases with age.
> Childhood vaccination against hepatitis
B is a cost-effective measure to prevent
adult morbidity and has been shown to
prevent the development of chronic carrier
status in more than 95% of vaccinated
children.
> Hepatitis B vaccine is the first and at
present the only cancer-preventive vaccine
It has already been demonstrated
to reduce the risk of hepatocellular carcinoma
in some high-incidence areas.
Hepatocellular carcinoma is one of the
most common and most lethal cancers
worldwide. The disease more commonly
affects males, and generally those in their
most economically productive years.
There is striking geographical variation in
incidence, with very high rates in South-
East and East Asia, the Pacific rim and
sub-Saharan Africa and much lower rates
in North America and Europe (Liver cancer,
p203).
The geographical distribution of chronic
hepatitis B virus (HBV) infection and hepatocellular
carcinoma is very similar (Figs.
4.14, 4.15). First discovered as a cause of
acute fulminant hepatitis in 1969, HBV
has since been identified as the major etiologic
agent in hepatocellular carcinoma
(Fig. 4.18). Subsequent research has documented
variations in disease outcomes
based on age of exposure, defined differences
in HBV transmission patterns
between high- and low-prevalence regions
and provided estimates of the risk for
chronic liver disease and hepatocellular
carcinoma associated with long-term HBV
144 Prevention and screening