Why Are There So Many Hepatitis B and Liver Cancer Patients in China?

During my college-entrance physical examination, out of a class of more than fifty students, nearly ten were found to have hepatitis B; unfortunately I was one of them. Fortunately I had only the "small three positive" (minor HBV carrier state), and over more than ten years of repeated checks the virus was always negative (HBV DNA below detection limit) with normal liver function.

Of course this does not mean I have not been affected by hepatitis B. In fact, my digestive function has been poor all these years; if I sleep insufficiently one night, for the following period my flanks feel distended and full, very uncomfortable. This is one of the classic symptoms of hepatitis patients.

After living more than ten years with my family in isolation-free conditions, no one else in my household contracted hepatitis B. Several classmates with similar experiences were mostly the same. This shows that the probability of transmitting hepatitis B through shared daily life is not high. But why did our generation have so many hepatitis B sufferers? According to incomplete statistics, the total number of HBV carriers and hepatitis B patients in China exceeds 100 million. I believe the answer can only be the poor medical conditions in China in the 1970s and 1980s: most infants were injected with syringes shared among many people during vaccination.

When I was a child, the village doctor who vaccinated us used needles reused repeatedly by many people. So-called "sterilization" meant boiling them in water; disinfection facilities were quite inadequate. Thus a whole generation contracted infectious diseases while being vaccinated against them. To this day, no party has stepped forward to point out this fact, nor has any institution taken responsibility.

In a conversation with a liver specialist at a Beijing Grade-A tertiary hospital, the expert told me that, from his many years of clinical experience, about one-third of hepatitis B patients will eventually progress to liver cirrhosis and liver cancer. This is a terrifying probability. The mistakes China made in infectious-disease prevention in the 1970s and 1980s will plunge our generation deep into the suffering of liver disease.

To this day we have not found a medicine that cures hepatitis B. Among the liver cancer patients I have encountered, the great majority developed from hepatitis B. One hepatitis B patient, treated decades ago by an old TCM doctor, achieved clinical cure—all six HBV markers turned negative—but this patient ultimately still, unfortunately, developed liver cancer. I have now encountered three such patients: hepatitis B cured, yet liver cancer eventually developed.

Primary liver cancer is one of the deadliest of cancers; more than half of the world's liver cancer patients come from China, and most primary liver cancers develop from HBV-related cirrhosis. Worldwide, more than 600,000 patients die of liver cancer each year. China is not yet at the peak of liver cancer incidence; as far as I know, China's largest group of hepatitis B patients are concentrated in an age bracket close to my own, and this group has not yet reached the peak period of malignant transformation.

In my own clinical treatment of cancer patients, I deeply know that liver cancer is the most intractable of cancers. Most liver cancer patients present with acute onset and short survival (generally less than half a year from discovery to death). Once other cancers develop liver metastases, treatment difficulty also increases greatly.

The reason I tirelessly study cancer is that I have already genuinely felt its threat. For years I have suffered from hepatitis B, chronic bronchitis, bronchial asthma, and chronic prostatitis—all regarded by modern medicine as precancerous lesions respectively of liver cancer, lung cancer, and prostate cancer. On top of that, my mother died of gastric cancer, so my own probability of developing gastric cancer is many times higher than normal. Hence I have an instinctive vigilance toward cancer.

The current cure rate for cancer in China is quite low, which is closely related to the underdevelopment of preventive medicine. For high-risk groups, we have still not taken the intervention measures we should. For instance, the hepatitis B patient population is huge and the probability of malignant transformation is high, yet China still has no health policy for intervening in hepatitis B patients.

Cancer prevalence in Western developed countries once reached over 30% of the total population—roughly one in every three people died of cancer, and nearly every family lost a member to cancer. Not long ago I saw reports that cancer prevalence in places like Guangzhou has now also reached over 30%; that is, Guangzhou and other industrially developed regions have entered an era where one in three people dies of cancer. China now has heavy social pressure and severe environmental pollution; cancer incidence is climbing rapidly, yet health prevention and control policy lags behind reality. As a hepatitis B patient, I have never received any official assistance. I believe other patients' experiences are much the same.

Judging from the Western history of fighting cancer, the path of pouring vast funds into finding cancer treatments is extraordinarily arduous and yields only trivial results. But if prevention is timely—screening and intervening in high-risk groups—the fatality rate of cancer can be greatly reduced. Patients whose cancer is detected early have a five-year survival rate above 70%, and a considerable proportion of early-stage cancer patients can be completely cured. The problem is that our cancer patients, once discovered, are mostly already at an advanced stage.

Beijing now sees 106 new cancer patients every day; cancer has become the number-one health killer of Beijing residents. These are statistics from Chinese health authorities, and the figure is deeply worrying. Ten years from now, cancer will, like a nightmare, become a grim reality that the great majority of Chinese families must face. Many of us who are now desperately making money will, in the future, have to spend our lifelong hard-earned savings on cancer treatment.

Sounding the alarm, understanding cancer, and staying away from cancer have very practical significance for contemporary Chinese people. I also hope that China's health authorities will do their work more concretely, increase investment in cancer prevention, and reduce the occurrence of tragedies. But for the moment, achieving this seems very difficult.

Patients with chronic illnesses like myself can only seek their own blessings. When policy cannot yet reach us, we must pay more attention to our own health, examine our bodies closely, treat promptly, and prevent tragedies.