Achievements and challenges of primary liver cancer prophylaxis in Shanghai, China

Liver cancer in mainland China alone accounts for more than half of global cases.The occurrence of LC is higher in the coastal areas than in other regions.In the past 40 years or more, the incidence and mortality of LC in Shanghai declined by nearly 50%.The main reason was that chronic infection of hepatitis B virus (HBV), contamination of drinking water, and exposure to aflatoxin in corn and peanut were identified as the most important risk factors(or causes) of LC in Shanghai and the surrounding Delta Region through long-term research.These findings led to active public health activity such as improvements in water treatment, rice protection, and HBV prevention in areas with high incidence of LC.These preventive measures achieved a lot in reducing the disease burden of LC.However, there are approximately 94 million chronic HBV infections.Of those, 32% males and 9% females are expected to die of LC before 75 years old.The current challenge in fighting against LC in China is to identify what kind of chronic HBV carriers who will develop LC and to carry out antiviral treatments for reducing or postponing the occurrence of LC.