Authors: Hellen Gelband, Chien-Jen Chen, Wendong Chen, Silvia Francheschi, Sir Andrew Hall, W. Thomas London, Katherine A. McGlynn, Christopher Wild
Hepatitis B (HBV) vaccination will significantly reduce worldwide incidence of liver cancer and cirrhosis, even in East Asia and Pacific and Sub-Saharan Africa which experience the highest rates. Incidence is shown to rise with age, but as countries increase their GDP, the occurrence of liver cancer typically declines. Major risk factors come from several sources: (1) hepatitis B virus which spreads through bodily fluids; (2) hepatitis C virus (HCV) which is primarily blood borne and can be transmitted by contaminated needle use; (3) aflatoxins which occur during crop cultivation and poor food storage conditions for maize and peanuts; (4) alcohol consumption; (5) liver flukes which are worms present in snails and raw fish; and (6) obesity. The most effective and cost-effective intervention is the HBV vaccination, followed by safe needle injections and blood transfusions to reduce spread of HCV. Antiviral therapies do exist for HBV and HCV but are extremely expensive making them unavailable in low- and middle-income countries.