‘B Positive’ Project – CEO’s message
Did you know that Australian residents born in Asia have a 6 to 12 time’s higher chance of getting Liver Cancer than someone born in Australia?
A substantial increase in the number of cases of primary liver cancer is expected over the next 20 years in the Asian-born communities in Australia (with a doubling in the number of cases of liver cancer among Australians born in China.) Of the approximately 300 cases of liver cancer diagnosed annually in NSW, approximately half are diagnosed in people born overseas.
Chronic infection with the hepatitis B virus is the most common cause of liver cancer among NSW residents born in Vietnam, China, Indonesia, Korea, Hong Kong and Macau, who are 6-12 times more likely to be diagnosed with liver cancer than Australian-born people. Hepatitis B infection contracted very early in life (as is the case in many Asian countries), leads to a very high likelihood of chronic infection, which remains asymptomatic but eventually leads to life-threatening complications in about 40% of people. This pattern of disease is also encountered among Indigenous Australians. For other Australian-born people, hepatitis B infection generally occurs in adolescence or adulthood and while the disease leads to symptoms in many people, they eventually clear the virus and do not progress to chronic infection and life-threatening disease.
Hepatitis B vaccination will eventually lead to substantial reductions in the burden of liver disease, but in the next 20-30 years, the burden of hepatitis B related disease will continue to rise in Australia, so controlling for the impact of chronic hepatitis is needed in the meantime, to avoid cirrhosis, liver failure and liver cancer in people with chronic infection.
Recent advances in hepatitis B treatment have demonstrated that detecting chronic hepatitis earlier, regular follow up and lifestyle changes and in some cases treatment with antiviral drugs can delay or prevent the development of liver cancer in these people. The Cancer Council NSW is trialing this type of cancer prevention intervention, which aims to reduce among people at high risk of developing liver cancer and other end-stage liver disease.
People from at-risk communities will be invited by their general practitioner to have a blood test for hepatitis B. If diagnosed with chronic infection, they will be offered additional testing to determine the stage and severity of their disease and define the type of follow up and treatment that best suits their condition. Determining their level of risk for liver cancer involves measuring the amount of hepatitis B virus in their blood (their viral load) and the effect this has on their liver. Some people may need just regular GP visits and blood tests (if their liver is not affected), while others may need specialist assessment, additional testing and treatment with antiviral drugs. Economic modelling showed that such a program could save approximately 300 lives in Sydney’s southwest, where most cases of liver cancer are being diagnosed.
The program relies on the capacity of the health system to support participants by providing no-cost testing and follow-up treatment via GPs and clinical Specialists, community awareness of the condition, willingness to be tested and treated and better general practitioner information about the disease and prevention strategies. Thank you for your interest and engagement in the implementation of the project & its associated community-based activities.
Dr Andrew Penman
Chief Executive Officer
