Background A nationwide hepatitis B vaccination program wasimplemented in Taiwan in July 1984. To assess the effect ofthe program on the development of hepatocellular carcinoma,we studied the incidence of this cancer in children in Taiwanfrom 1981 to 1994.
Methods We collected data on liver cancer in children from Taiwan'sNational Cancer Registry, which receives reports from each ofthe country's 142 hospitals with more than 50 beds. Data onchildhood liver cancer were also obtained from Taiwan's 17 majormedical centers. To prevent the inclusion of cases of hepatoblastoma,the primary analysis was confined to liver cancers in childrensix years of age or older. Data were also obtained on mortalityfrom liver cancer among children.
Results The average annual incidence of hepatocellular carcinomain children 6 to 14 years of age declined from 0.70 per 100,000children between 1981 and 1986 to 0.57 between 1986 and 1990,and to 0.36 between 1990 and 1994 (P<0.01). The correspondingrates of mortality from hepatocellular carcinoma also decreased.The incidence of hepatocellular carcinoma in children 6 to 9years of age declined from 0.52 for those born between 1974and 1984 to 0.13 for those born between 1984 and 1986 (P<0.001).
Conclusions Since the institution of Taiwan's program of universalhepatitis B vaccination, the incidence of hepatocellular carcinomain children has declined.
Source Information
From the Department of Pediatrics (M.-H.C.) and the Hepatitis Research Center (D.-S.C.), College of Medicine, and the Graduate Institute of Epidemiology, College of Public Health (C.-J.C., W.-Y.S.), National Taiwan University, Taipei; the Department of Health, Executive Yuan, Taipei (M.-S.L., H.-M.H.); the Department of Pediatrics, Veterans General Hospital, Taipei (T.-C.W.); the Department of Pediatrics, Chang-Gung Children's Hospital, Linkou, Taoyuan (M.-S.K.); and the Department of Pediatrics, Mackay Memorial Hospital, Taipei (D.-C.L.) — all in Taiwan.
Address reprint requests to Dr. Chang at the Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Rd., Taipei, Taiwan.
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