Background/Aim
s: To optimize efficacy of National Liver Cancer Screening Program (NLCSP)
for subjects with chronic hepatitis B (CHB), it is needed to know the incidence of liver cancer
and its predisposing factors in the program.
Methods
From January 2010 to December 2014, all the hepatitis B surface antigen (HBsAg)
positive participants who received at least two or more abdominal ultrasonography under
NLCSP were retrospectively enrolled in a single tertiary hospital. Annual incidence of primary
liver cancer was calculated and related clinical factors were investigated.
Results
During 5 years, 541 subjects were enrolled. Mean age was 53 years old and 292
subjects (54%) were receiving antiviral agents. Liver cirrhosis (LC) was diagnosed in 212 (39.2%).
Mean follow-up time was 2.36 years and 15 hepatocellular carcinoma and 1 intrahepatic
cholangiocarcinoma were diagnosed. Annual incidence of primary liver cancer was 9.8
per 1,000 patient year. Cumulative incidence at 1, 3, and 5 year was 0.6%, 2.6%, and 6.4%,
respectively. In multivariate analyses, LC (hazard ratio [HR] 8.74, 95% confidence interval [CI]
1.97–38.71, P=0.024), age (HR 1.08, 95% CI 1.01–1.15, P=0.024) were significantly associated
with cancer development.
Conclusions
Despite of high rate of oral antiviral therapy, incidence of primary liver cancer
is not low in CHB patients in Korea. Old age and presence of LC are independently associated
with higher risk of cancer development during surveillance. This study could be used as
baseline data for quality control of NLCSP.