Survey of hepatitis B virus infection for liver cancer screening in China: A population-based, cross-sectional study

Yongjie Xu; Changfa Xia; He Li; Maomao Cao; Fan Yang; Qianru Li; Mengdi Cao; Wanqing Chen

doi:10.1097/CM9.0000000000003171

Survey of hepatitis B virus infection for liver cancer screening in China: A population-based, cross-sectional study

Chin Med J (Engl). 2024 May 20. doi: 10.1097/CM9.0000000000003171. Online ahead of print.

Authors

Yongjie Xu¹, Changfa Xia¹, He Li², Maomao Cao¹, Fan Yang¹, Qianru Li¹, Mengdi Cao¹, Wanqing Chen¹

Affiliations

¹ Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
² Office of National Cancer Regional Medical Centre in Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China.

PMID: 38766992
DOI: 10.1097/CM9.0000000000003171

Abstract

Background: Hepatitis B virus (HBV) infection is the primary cause of hepatocellular carcinoma (HCC) in China. The target population for HCC screening comprises individuals who test positive for hepatitis B surface antigen (HBsAg). However, current data on the prevalence of HBV infection among individuals who are eligible for HCC screening in China are lacking. We aimed to assess the seroepidemiology of HBV infection among Chinese individuals eligible for HCC screening to provide the latest evidence for appropriate HCC screening strategies in China.

Methods: Questionnaires including information of sex, age, ethnicity, marital status, educational level, source of drinking water, as well as smoking and alcohol consumption history and serum samples were collected from females aged 45-64 years and males aged 35-64 years in 21 counties from 4 provinces in eastern and central China between 2015 and 2023. Enzyme-linked immunosorbent assay methods were used to detect the serum HBV marker HBsAg.

Results: A total of 603,082 individuals were enrolled, and serum samples were collected for analysis from January 1, 2015 to December 31, 2023. The prevalence of HBsAg positive in the study population was 5.23% (31,528/603,082). The prevalence of HBsAg positive was greater in males than in females (5.60% [17,660/315,183] vs . 4.82% [13,868/287,899], χ 2 = 187.52, P <0.0001). The elderly participants exhibited a greater prevalence of HBV infection than younger participants (χ 2 = 41.73, P <0.0001). Birth cohort analysis revealed an overall downward trend in HBV prevalence for both males and females. Individuals born in more recent cohorts exhibited a lower prevalence of HBV infection as compared to those born earlier.

Conclusions: The current prevalence of HBV infection remains above 5% in populations eligible for HCC screening in China. Further efforts should be made to increase the accessibility of HCC screening among individuals with HBV infection.