Hepatocellular carcinoma in children

Hepatocellular carcinoma (HCC) is one of the most frequent malignancies in humans. Although it occurs mainly in adults of 40 to 60 years of age, it may develop in children. It mainly occurs in children older than six years of age, with male predominance. Children with chronic hepatitis B virus (HBV) infection and underlying metabolic diseases are the two main high risk groups for childhood HCC. HBV infection is the main cause of childhood HCC in areas hyperendemic for HBV infection. In Taiwan, nearly 100% of HCC children were hepatitis B surface antigen seropositive. Maternal transmission (94%) is the most important route of transmission of HBV infection in HCC children. For HBV related HCC in children, immunization is the most effective way for the control of childhood HCC. The first universal vaccination against HBV in the world was launched in Taiwan in July 1984. The prevalence of hepatitis B surface antigenemia in children declined from 10% in 1984, prior to the vaccination program, to <1% in 1994, 10 years after the implementation of the program, in children less than 9 years of age. The annual incidence of HCC in children aged 6 to 9 years of age also decreased from 0.52 per 100,000 born in 1974-1984 to 0.13 per 100,000 born in 1984-1986.