DataSheet_1_Accelerating Decreases in the Incidences of Hepatocellular Carcinoma at a Younger Age in Shanghai Are Associated With Hepatitis B Virus Vaccination.docx

BackgroundRoutine vaccination of infants for protecting against hepatitis B virus (HBV) infection and its serious consequences, including hepatocellular cancer (HCC), has been carried out in Shanghai, China, since 1986. We therefore have examined the trend of HBV infection and HCC incidences before and after HBV vaccination over decades to assess the potential influences of the Shanghai HBV vaccination program.MethodsData on incidences of HBV infection and HCC were collected from the Shanghai Cancer Registry and the Shanghai HBV vaccination follow-up study. Joint-point regression and the Bayesian age-period-cohort statistical analysis methods were used.ResultsThe incidences of HBV infection dramatically declined from 23.09 and 1.13 per 100,000 for males and females in 2000 to 3.24 (-85.97%) and 0.22 (-80.53%) per 100,000 in 2014, respectively. Sero-epidemiological data from the sampling surveys during 20 years of follow-up showed that less than 1% of people undergoing HBV vaccination have a positive serum HBsAg. Consistently, the annual adjusted standardization rates (ASR) of HCC steadily fell from 33.38 and 11.65 per 100,000 for males and females in 1973 to 17.34 (-49.2%) and 5.60 (-51.9%) per 100,000 in 2014, respectively. The annual percentage change in overall HCC incidences is about -2%. HCC incidences in males at younger age groups (age

自1986年以来，中国上海市已对婴幼儿进行乙型肝炎病毒（HBV）感染及其严重后果，包括肝细胞癌（HCC）的保护性预防接种。因此，本研究对HBV疫苗接种前后数十年的HBV感染和HCC发病率趋势进行了考察，以评估上海HBV疫苗接种计划的潜在影响。方法：本研究收集了来自上海市癌症登记处和上海市HBV疫苗接种随访研究的HBV感染和HCC发病率数据。采用了联合点回归和贝叶斯年龄-时期-队列统计分析方法。结果：HBV感染的发病率在2000年的男性和女性分别为每10万人23.09和1.13例，到2014年分别降至每10万人3.24例（下降85.97%）和0.22例（下降80.53%）。在20年的随访期间，采样调查的血清流行病学数据显示，接受HBV疫苗接种的人群中，血清HBsAg阳性率低于1%。一致地，男性女性的肝细胞癌的年度调整标准化率（ASR）从1973年的每10万人33.38和11.65例，稳步下降到2014年的每10万人17.34例（下降49.2%）和5.60例（下降51.9%），总体HCC发病率的年变化百分比约为-2%。在年轻年龄组的男性中，HCC发病率呈现下降趋势。