Trends in the Incidence of Hepatocellular Carcinoma in Boys and Girls in
Taiwan after Large-Scale Hepatitis B Vaccination
Cheng-Liang Lee, Kai-Sheng Hsieh and
Ying-Chin Ko1
Department of Pediatrics, Kaohsiung Veterans General Hospital
and Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung
[C-L. L.]; Department of Pediatrics, Kaohsiung, Veterans General Hospital,
Kaohsiung [K-S. H.]; and Department of Public Health, School of Medicine,
Kaohsiung Medical University, Kaohsiung [Y-C. K.], Taiwan
In July 1984, large-scale hepatitis B vaccination of newbornsbegan in Taiwan. Vaccination decreased the overall incidenceof
childhood hepatocellular carcinoma (HCC). We conducted thisstudy to
learn whether the vaccination program had the sameeffect on boys and
girls. We collected liver carcinoma (includingHCC and hepatoblastoma)
deaths from 1974 to 1999 from the TaiwanMortality Registry and the
19741999 population data fromthe Taiwan Ministry of Interior to
calculate the liver carcinomamortality rate. The populations ages
014 and ages 15100in each calendar year were treated as the study
group and thereference group, respectively. We divided the 19741999calendar years into 4-year strata and calculated the mortality
rates of each 4-year period. We used the 19801983 mortalityrate as
the standard to calculate 4-year-interval mortalityrate ratios.
Vaccination effects by age and gender were estimateddividing the
study and the reference groups into male and femalesubgroups. We
used a double-comparison method to confirm theeffects of hepatitis B
vaccination: the mortality rate trendof the study group (ages 014)
compared with the referencegroup (ages 15100) in the same period
(19841999),and the mortality rate trend of the study group (age
014)compared with itself in the pre- and postvaccination periods(19741983, 19841999). Liver carcinoma mortalitydecreased
significantly among both males and females after 1984.In the study
group, the male mortality rate decreased by upto 70%, and the female
mortality rate decreased by up to 62%in the 19961999 interval
compared with the 19801983period. Both the male and the female
study groups mortalityrate trends decreased from 1983 to 1999
compared with the 19741983period or compared with the same period
of the reference groups.Our results indicate hepatitis B vaccination
decreases childhoodHCC in both boys and girls.
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"