title: Hepatitis B vaccination and liver cancer mortality reduction in Korean children and adolescents.
abstract: Liver cancer is one of the three most common causes of cancer mortality in the world and it is closely related to chronic hepatitis B viral (HBV) infection in Korea. The decline of HBV prevalence for the last two decades in Korea might be partly due to the HBV vaccination, which was implemented as a national program starting in 1995. The aim of this study was to assess the period effect of the national HBV vaccination on liver cancer mortality in a young population. We compared age-specific mortality rates of liver cancer before and after the national vaccination program in the Korean population under the age of 20. To reduce year-to-year fluctuations in mortality, calendar years and age groups were divided into 4-year strata and the mortality rates were calculated for each stratum. Period effects of the national vaccination program were analyzed using age-period-cohort modeling. A total of 370 liver cancer mortality cases were identified during the period from 1991 to 2006. The period effect of the national vaccination program for the period 2002-2006 had a significantly reduced liver cancer mortality rate when compared to the period 1991-1994 when the national vaccination program was not implemented (RR 0.30, 95% CI 0.21~0.44). After implementation of the national vaccination program, HBV prevalence in Korean declined from 6~8% to 2~3%. This study demonstrates that the national vaccination program has contributed to the reduction of liver cancer mortality beyond just a natural decrease in Korean children and adolescents.
authors.affiliation: Division of Epidemic Intelligence Service, Korea Center for Disease Control and Prevention, Osong, Korea.
authors.forename: Jin
authors.initials: J
authors.lastname: Gwack
authors.forename: Sue K
authors.initials: SK
authors.lastname: Park
authors.forename: Eun-Ha
authors.initials: EH
authors.lastname: Lee
authors.forename: Boyoung
authors.initials: B
authors.lastname: Park
authors.forename: Yunhee
authors.initials: Y
authors.lastname: Choi
authors.forename: Keun-Young
authors.initials: KY
authors.lastname: Yoo
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007723:Korea / Q000453:epidemiology; D008113:Liver Neoplasms / Q000401:mortality* / Q000517:prevention & control / Q000821:virology*; D015995:Prevalence; D055815:Young Adult
chemical_list: D017325:Hepatitis B Vaccines