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6. What is the connection between HBV and liver cancer?

Now basically I think when Molli asked me to talk about this and gave me the title “Making the Link” I thought well this is actually the person who should be giving the talk, because it was Dr. Beasley and his team of investigators in Taiwan who really made the connection between hepatitis B and liver cancer. I had the pleasure of actually giving a talk with him recently at Harvard in a Jade forum organized by the Hepatitis B Initiative in Boston. I also had the pleasure of meeting Dr. Tom London who did a lot of work to find an association and genetic factors associated with chronic hepatitis B and liver cancer. So it was Dr. Beasley that at a time, back in the 70’s when a lot of people thought Aflatoxin was the substance which caused liver cancer. Aflatoxin is a substance that could be produced in moldy peanuts so all of the sudden in China, everybody said don’t use peanut oil to cook because of this concern, right? But actually it was him in the study and his colleagues in Taiwan who conducted a study of 22,000 government workers in Taipei and found that the risk of liver cancer is sixty times higher in chronic hep B infected patients, which a lot of people don’t realize. This association is much higher than the association between lung cancer and smoking. And what he calculated is if you have chronic hepatitis B, especially those who acquire it during birth or early childhood, the lifetime risk of dying from liver cancer is forty percent in men and fifteen percent in women. So that is why when we say you have chronic hepatitis B, you have a twenty-five percent chance of dying from hepatitis, you know liver cancer or liver cirrhosis, because if you average it out, it is about twenty-five percent. So actually the risk is even higher in men.