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HOME > J Liver Cancer > Volume 17(2); 2017 > Article
Original Article Incidence of Primary Liver Cancer in Subjects with Chronic Hepatitis B in Korean National Liver Cancer Screening Program
In Seung Choi1, Chi Hyuck Oh1, So Young Park1, Sung Eun Ahn2, Seong Jin Park2, Hyun Rim Choi3, Byung-Ho Kim1, Jae-Jun Shim1
Journal of Liver Cancer 2017;17(2):136-143
DOI: https://doi.org/10.17998/jlc.17.2.136
Published online: September 30, 2017
1Departments of Internal Medicine,Kyung Hee University School of Medicine, Seoul, Korea
2Departments of Radiology, Kyung Hee University School of Medicine, Seoul, Korea
3Departments of Occupational and Environmental Medicine, Kyung Hee University School of Medicine, Seoul, Korea
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Background/Aims
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.

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