We stand equal in the front of science.
Your selective deletions of the comments expressing different opinions or questioning the scientific validity of your blog are not professional. Please be professionally open-minded and stop misleading our fellows. Again, a scientific hypothesis is far from a proven scientific reality.
Sorry if we missed your point that focuses on those Chinese who are born in USA. So where is the evidence indicating that those carrying mutants of aldehyde dehydrogenase have a higher risk or incidence of hepatocellular carcinoma compared to those with no mutations in the enzyme? Theoretical deduction often differs from scientific reality. If one thinks there might be a causal link between a factor and a thing, one should look into specific evidence or do studies to demonstrate that link is a case. The information you provided does not provide any evidence showing the incidence of hepatocellular carcinoma is higher in Chinese with ALDH mutants than those without. I admire your scientific imagination ability, but we need evidence to see whether the imagination stands right. So far, inactive ALDH mutations have not been established or recognized as a risk factor for hepatocellualr carcinoma. This is different from whether alcohol is a risk factor for the disease.
As a specialist, I hate to say that your article is relatively misleading although I congratulate you for your efforts in awaking our fellow about the risk of alcohol. Some cancers show an increased risk in Asian immigrants after years of being in USA; however, it is unclear if Chinese immigrants have a sustained high risk of hepatocellular cancer after coming to USA. IF one really wants to find out whether hepatocellular cancer is related to the genetics of Chinese, one better to study the second generation of Chinese since the first generation has carried over some risk factors such as HBV, regardless of being active or recovery. A history of HBV infection means the viral DNA has been integrated into one's hepatocytes' DNA, which can interfer with normal hepatocytes somewhere and sometimes.
I would not have argued with you if you had said genetics was one of the reasons. I say genetics, not only the genetic mutation associated with alcohol. We still don't understand why people get cancer. But, it is sure that people who develop cirrhosis due to hepatitis B/C and alcoholic hepatitis are at much higher risk to develop hepatocelluar carcinoma.
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Why Eradicating Hepatitis B and Liver Cancer should be a National Priority in China
根除乙肝和肝癌-中国首要任务
Professor Samuel So
Asian Liver Center at Stanford University
(Presented at the China National Conference on Hepatitis Prevention and Control,
Hangzhou, China, April 26-29, 2004)
If you judge by the focus of international and media reports, you would think that
HIV/AIDS, SARS, and the avian flu, are the major health problems facing China today.
An estimated 17,000 people died of HIV in 1999, and by 2003, approximately a million
people in China is living with HIV. In response to this rising threat, a national plan for
AIDS prevention and control (1998-2010) has been developed and adopted. During the
SARS outbreak in 2003, 5327 people in China were infected and 349 died of SARS. To
date, there has been no report of death from avian flu in China. In contrast, hepatitis B
which poses the greatest threat to the health of the nation has received little attention.
One in ten Chinese (130 million) has chronic hepatitis B. In China, every 60 seconds, a
person die from liver cancer or liver failure caused by hepatitis B. Hepatitis B is the
greatest health threat and the “silent killer” in the Chinese community.
China has the greatest burden of hepatitis B and liver cancer in the world. Of the 350-400
million people with chronic hepatitis B, a third of them live in China. Hepatitis B is
transmitted the same way as HIV/AIDS and not by food or casual contact. Many Chinese
became infected at childbirth when the mother is a hepatitis B carrier. Others became
infected by injections or cuts with needles, syringes, medical or dental instruments, and
blood contaminated with hepatitis B, or from unprotected sex. Most chronically infected
individuals don’t even know they have been infected because they often feel perfectly
healthy. By the time symptoms developed, it is often too late. The reason chronic
hepatitis B is so dangerous is because without treatment or regular screening for liver
cancer, one in four chronically infected person will eventually die of liver cancer or liver
failure. Many die at their prime of live and as early as 30 years of age when they have
many family responsibilities. Each year, an estimated half a million Chinese die of liver
cancer or liver failure caused by hepatitis B.
What is so tragic is that hepatitis B and liver cancer is largely preventable. The hepatitis
B vaccine is a safe and effective vaccine that can protect the uninfected Chinese
population from HBV infection and the development of liver cancer. For this reason, the
Center of Disease Prevention and Control (CDC) in the US called the HBV vaccine the
first “anti-cancer vaccine”. And even for those who have chronic HBV infection (often
referred to as HBV carriers), most could lead normal, working lives. Many will not die
with treatment of hepatitis B to prevent further damage to the liver, and regular
monitoring to detect the cancer at an early stage when it could be successfully treated.
2
The health of the young people in China holds the key to the future of the country.
Children under the age of 18 years comprise of 29% of the population of China and 19
million babies are born every year. Although the adoption of a national policy since
January 1st 2002, to provide newborn with free HBV vaccination is an important initial
step towards reducing the incidence of hepatitis B, many children and young adults are
left vulnerable to HBV infection. Many parents and healthcare providers are still not
sufficiently informed about the benefits and importance of the HBV vaccine. Lessons
learnt from the CDC in the US from a 20-year experience show that an effective HBV
vaccination strategy must target not only the newborn, but provide HBV screening for all
pregnant women, and catch-up vaccination for all children and young adults who remain
vulnerable to infection. Special programs to increase awareness and education of the
parents and healthcare providers are important in improving the completion rates of the
three-dose vaccine.
Despite the prevalence of hepatitis B and liver cancer in the Chinese community, many
including physicians are not aware of the risk, the association of hepatitis B and liver
cancer, the importance of HBV vaccination to prevent liver cancer, and the need for
hepatitis B carriers to have regular liver cancer screening. Many are further confused
about how hepatitis B is transmitted creating unfounded prejudices against those who are
chronically infected. The Asian Liver Center at Stanford University was founded in 1996
with the goal of eradicating hepatitis B worldwide and reduces the incidence and motility
of liver cancer through a three-pronged approach: research, treatment, and prevention and
early detection through education and advocacy. The Jade Ribbon Campaign to fight
hepatitis B and liver cancer was launched in 2001 by the Asian Liver Center at Stanford
University. Partners of the campaign include the CDC, federal and state health agencies,
and hundreds of community organizations and corporations. The campaign aims to raise
awareness and educate both the public and the healthcare communities about the
importance of hepatitis B testing and vaccination, and the prevention of liver cancer. We
picked the color “jade” because it brings good luck and good health. Folded like the
Chinese character meaning “people”, the Jade Ribbon is symbolic of the spirit of the
campaign in uniting the people throughout the world together to eliminate hepatitis B and
liver cancer, and build a healthier community.
References
World Health Organization (WHO). http://www.who.int/csr/sars/country/en/
Joint United Nations Programme on HIV/AIDS (UNAIDS)
http://www.unaids.org/nationalresponse/result.asp?action=overall&country=529
United Nations Children’s Fund (UNICEF).
http://www.unicef.org/infobycountry/china.html
Asian Liver Center at Stanford University.
http://liver.stanford.edu/index2.asp?lang=eng&page=statistics
The United States Centers for Disease Control and Prevention (CDC).
http://www.cdc.gov/ncidod/diseases/hepatitis/b/
Sun Z, Ming L, Zhu X, Lu J. Prevention and control of hepatitis B in China. J Med Virol
67:447-50, 2002.