About Viral Hepatitis and Liver Cancer Awareness Month
Hepatitis Awareness Month in May is an annual observance that provides a specific opportunity to promote awareness of hepatitis and also the link between hepatitis B, hepatitis C and liver cancer. National Hepatitis Testing Day on May 19th provides an opportunity to encourage at-risk communities to get tested for viral hepatitis [1].
October is Liver Cancer Awareness Month [2]. This month provides an opportunity for the wider cancer control community and institutions to promote awareness among providers and the public about liver cancer risk reduction through viral hepatitis prevention, screening and treatment.
Data and Statistics
In 2019, the latest year for which incidence data is available, in the United States, 35,563 new cases of liver and intrahepatic bile duct cancer were reported, and 27,958 people died of this cancer [3]. For every 100,000 people, eight new liver and intrahepatic bile duct cancer cases were reported and seven people died of this cancer [3].
Basic Facts About Viral Hepatitis and Liver Cancer
Despite the strong link between viral hepatitis and liver cancer, many individuals may not know about hepatitis B or hepatitis C virus infections as major risk factors. Chronic hepatitis B and C are lifelong infections that are clinically silent in most patients [4]. Approximately two-thirds of people infected with hepatitis B and approximately half of people infected with hepatitis C are unaware of their condition [5].
- Liver cancer is the fastest-growing cause of cancer deaths in the United States. New liver cancer cases increased 38% and liver cancer deaths increased 56% between 2003 and 2012 [4].
- Hepatitis B and hepatitis C infections cause about 80% of the world’s hepatocellular carcinoma worldwide, the most common form of liver cancer. Other causes of liver cancer include excessive alcohol consumption, obesity, non-alcoholic fatty liver disease, rare metabolic disorders, and type II diabetes [4].
- Liver cancer caused by chronic hepatitis B can be prevented through hepatitis B vaccination, or early detection and treatment of hepatitis B infections [4].
- Chronic hepatitis C can be cured with effective treatment, reducing the risk of liver cancer [4].
Best Practices for Communicating About Viral Hepatitis and Liver Cancer
Highlight the link between viral hepatitis and liver cancer, and increase knowledge about how viral hepatitis is transmitted, prevented, and treated
- Encourage health care providers to learn about who is at risk of viral hepatitis and promote testing for chronic hepatitis B and hepatitis C infections. Examples of individuals at high risk of hepatitis B include men who have sex with men, people who inject drugs, people with HIV, and pregnant women [6]. Additionally, all adults aged 18 years and older should be tested for hepatitis C, including pregnant individuals and people who have ever injected drugs or shared needles [6]. Missed opportunities for prevention through vaccination and lack of awareness of infection are some of the challenges to eliminating viral hepatitis [7]. Health care providers can provide recommendations on vaccination, screening, prevention counseling, and referrals for additional health care services [7].
- Encourage health care providers to promote hepatitis B vaccination as cancer prevention. Lack of perceived patient risk was also cited as a barrier to compliance [8].
- Carry out simple on-site education interventions to improve knowledge and acceptability of viral hepatitis testing and build critical partnerships to reach communities disproportionately affected [9]. Baseline knowledge about hepatitis C is poor among high-risk populations like injection drug users [9].
Educate communities and health care providers about populations likely to be affected
- Educate communities that viral hepatitis and liver cancer starts with prevention. There is an effective vaccine for hepatitis B and approximately 90% of children under three are fully immunized, but only about a quarter of adults are fully immunized. Vaccination efforts should focus on populations at increased risk [4].
- Reduce transmission of existing infections to prevent viral hepatitis and liver cancer. A simple blood test can screen for infection, and both hepatitis B and C are treatable. Harm reduction strategies may help reduce transmission among people who inject drugs and those who are incarcerated [4].
- Encourage providers to increase collection of data on risk factors for chronic hepatitis B and hepatitis C infections. Data can help us understand the burden of viral hepatitis, identify trends in patient characteristics, risk factors, and geographic areas, which in turn helps focus resources in communities and settings where they can be most impactful [7].
Decrease stigma around hepatitis B and hepatitis C infections
- Recognize that individuals affected by viral hepatitis infections may feel stigmatized. Perceived stigma associated with hepatitis C infections can lead to anxiety and excessive fear of transmission, often resulting in social isolation and reduced intimacy in relationships [10-11].
- Encourage providers to recognize their own bias regarding those infected with hepatitis C virus [10].
- Raise awareness about viral hepatitis infections and normalize screening for recommended groups.
Debunk commonly held misconceptions and myths
- Address misbeliefs regarding hepatitis B infection, such as the belief that hepatitis B could be spread through sharing food or utensils or through the air [12]. Some individuals may not realize that chronic hepatitis B infection may be a result of perinatal transmission, which occurs when a parent infected with hepatitis B passes the infection to their infant during pregnancy [13].
- Educate communities that hepatitis C infection can be cured. In a survey of a high-risk urban population, most respondents were not sure or did not think that hepatitis C could be cured, and over half expressed misunderstandings regarding treatment side effects [9].
- Affirm that individuals should not understate their risk of chronic hepatitis. Individuals should not assume that health care providers will tell them they need to be tested. Healthcare providers should not assume that patients will display obvious symptoms such as yellow eyes [12].
Communicating with Diverse Audiences
Certain groups experience disparities in viral hepatitis screening, incidence, mortality, and survival [14]. Health disparities are complex and affected by various factors, such as social determinants of health, behavior, biology, genetics, and more [14].
An annual report from the American Cancer Society, CDC, the National Cancer Institute (NCI) and the North American Association of Central Cancer Registries noted that between 2010 and 2014, death rates associated with liver cancer increased in White, Black and Hispanic men and women and American Indian/Alaska Native men, with more than twice as many men diagnosed with liver cancer as women across all racial/ethnic groups [15].
Below you will find additional considerations for these specific audiences, including: Black/African American, Hispanic/Latin/x/o/a, Asian Americans, Native Hawaiians and Pacific Islanders [AANHPI], and American Indian/Alaska Native [AI/AN], LGBTQI+ individuals and other at-risk groups.
Communication-related issues may also play a role in cancer disparities [16]. Consider the information most useful to each diverse group. It is important to tailor communication to these populations of focus with messaging that also addresses conditions where these communities live, learn, work and play, as these factors can impact a wide range of health risks and outcomes [17].
Viral Hepatitis and Liver Cancer Resources
Resource | Description |
---|---|
The ABCs of Viral Hepatitis | The ABCs of Viral Hepatitis provides basic information for health care providers and community members about how hepatitis B and hepatitis C are transmitted. |
CDC’s Know Hepatitis B | CDC’s Know Hepatitis B initiative provides prevention and treatment information specifically for Asian Americans/Pacific Islanders. |
CDC’s Know More Hepatitis | CDC’s Know More Hepatitis initiative provides information and resources on hepatitis C. |
CDC’s National Get Tested Website | Provides testing information and locations across the U.S. |
Coalition Against Hepatitis for People of African Origin | This national community coalition works with community partners across the U.S. to raise awareness about hepatitis B, particularly among African immigrants. |
Comprehensive Cancer Control National Partners- Increase Hepatitis B Virus (HBV) and Human Papillomavirus (HPV) Vaccination Uptake Hepatitis B Virus (HBV) and Cancer Prevention Resource List | The Comprehensive Cancer Control National Partnership (CCCNP) is focused on providing technical assistance and capacity-building for CCC coalitions to increase HBV and HPV vaccination and reduce vaccine-preventable cancers. The Vaccine- Preventable Cancers workgroup with the National Partnerships has compiled resources to help CCC coalitions working on HBV. |
Hep B United | Hep B United works with local coalitions to raise community awareness and hold vaccination, screening and testing events, particularly for Asian American communities. |
Liver Cancer | Information on liver cancer provided by the CDC. |
Strategies to Reduce Viral Hepatitis-Associated Liver Cancer | Summarizes National Academy of Sciences report findings in a cancer context for use by policy makers and the cancer community. |
The University of New Mexico’s Project ECHO | The University of New Mexico’s Project ECHO provides training to primary care clinicians to provide specialty care services, and has “transferable lessons for building capacity in primary care” (NASEM, 2017). |
University of Washington National Hepatitis Training Center | The University of Washington National Hepatitis Training Center offers free educational resources for clinicians on hepatitis B and hepatitis C. |
U.S. Department of Veterans Affairs | Brochures and patient education materials for veterans affected by viral hepatitis. |
Viral Hepatitis and Liver Cancer Prevention Profiles | These state-specific and general profiles help improve policy makers and cancer control professionals’ awareness of viral hepatitis risk factors and evidence-based prevention strategies, including PSE strategies to reduce the burden of viral hepatitis and liver cancer nationwide. |
Viral Hepatitis and Liver Cancer Awareness Month Messages and Graphics
Message | Suggested Graphic |
---|---|
October is #LiverCancer awareness month! Learn about the viruses that cause 60%+ of liver cancer http://bit.ly/2pyU0QF | Download Image |
Learn more about testing recommendations for hepatitis C virus http://bit.ly/2hZwEP6 | Download Image |
#DYK the important differences between hepatitis B and C infections? Browse these CDC fact sheets to learn more: https://bit.ly/3bYqC3q | Download Image |
#DYK #hepatitisB is common among #AsianAmericans? Talk to your doc about getting tested: https://bit.ly/3kXIjyW | Download Image |
How is #hepatitisC spread? Get the facts from | Download Image |
Men who have sex with men are at risk for viral hepatitis. Get the facts and talk to your doc about getting vaccinated: https://bit.ly/3pqSRuO #GWCC #KnowHepB | Download Image |
Check out @CDChep’s “Know More Hepatitis” campaign & spread the word on the impact of #HepatitisC on all adults: http://bit.ly/2nLIAuH | Download Image |
Hispanic/Latinx/a/o persons are more likely to be affected by #viralhepatitis & #LiverCancer. Learn more about it here https://bit.ly/3PtOWb9 | Download Image |
Maintaining a healthy weight, reducing your alcohol intake, and getting vaccinated for #HepB and tested for #HepC are some ways to reduce the risk of #LiverCancer #GWCC #KnowHepB #KnowHepC https://bit.ly/3bZ4FRQ | Download Image |
Public health professionals, address viral hepatitis-related liver cancer through #PSE approaches. Read this fact sheet for some ideas: https://bit.ly/2JJ3hTu | Download Image |
An estimated 41% of US adults have delayed or avoided medical care because of the #pandemic. Talk to your doctor about safely resuming viral hepatitis screening, care, and next steps. #GWCC #KnowHepB #KnowHepC #LiverCancerAwareness | Download Image |
Message | Suggested Graphic |
---|---|
October is Liver Cancer Awareness Month. Did you know viral hepatitis B and C cause more than 60% of the most common form of liver cancer? Learn about viral hepatitis and liver cancer prevention: http://bit.ly/2pyU0QF #GWCC #KnowHepB #KnowHepC | Download Image |
Viral hepatitis can cause #livercancer. Do you know if you or your loved ones should be tested? Learn about testing recommendations: http://bit.ly/2hZwEP6 #KnowHepC #GWCC | Download Image |
You’ve heard of hepatitis B and C, but do you know the important differences between these viral infections? Hepatitis B and C can progress to lifelong infections with serious illnesses like #liver #cancer. Learn more from CDC: http://bit.ly/2jcOz6h #GWCC #KnowHepB #KnowHepC | Download Image |
#HepatitisB is common among #AsianAmericans, but most don’t know. Talk to a doctor about getting tested for hepatitis B if you or your parents were born in Asia or the Pacific Islands: https://bit.ly/3kXIjyW #GWCC #KnowHepB | Download Image |
Can you get #hepatitisC from casual contact with an infected person? No! It usually spreads when blood from a person infected with hepatitis C enters the body of someone who is not infected. Read this info here: http://bit.ly/2na0CTh #GWCC #KnowHepC | Download Image |
Among adults, men who have sex with men are at risk for hepatitis A and B. Learn more about how to protect yourself and talk to your doctor about getting vaccinated: https://bit.ly/3pqSRuO #GWCC #KnowHepB | Download Image |
CDC is leading a national education campaign called “Know More Hepatitis” to decrease the burden of chronic viral hepatitis by increasing awareness and encouraging adults who may be infected to get tested. Check it out: http://bit.ly/2nLIAuH #GWCC #KnowHepC | Download Image |
Did you know #AmericanIndian and #AlaskaNative communities are disproportionately affected by hepatitis C infections? Get the facts: https://bit.ly/3pq6dHJ #GWCC #KnowHepC | Download Image |
Some populations such as Hispanic/Latinx/a/o persons are largely affected by #viralhepatitis & #livercancer. Learn more about how you can prevent it: https://bit.ly/3PtOWb9 #GWCC | Download Image |
Maintaining a healthy weight, avoiding excessive amounts of alcohol, getting vaccinated for #HepB and tested for #HepC are some ways to reduce the risk of liver cancer. Learn more during #LiverCancer Awareness Month here: https://bit.ly/3bZ4FRQ #GWCC #KnowHepB #KnowHepC | Download Image |
Public health professionals, address viral hepatitis-related liver cancer through #PSE approaches. Read this fact sheet for some ideas: https://bit.ly/2JJ3hTu #GWCC #livercancer | Download Image |
An estimated 41% of US adults have delayed or avoided medical care because of the #pandemic. Talk to your doctor about safely resuming viral hepatitis screening, care and next steps. #GWCC #KnowHepB #KnowHepC #LiverCancerAwareness | Download Image |
Message | Suggested Graphic |
---|---|
Health care professionals: Did you know CDC offers tools and resources for you to talk about viral hepatitis with your patients? Get the latest info here: http://bit.ly/2jkSJwM #GWCC #KnowHepB #KnowHepC | Download Image |
Providers, take time to identify patients at risk for #Hepb or #HepC. The University of Washington National Hepatitis Training Center offers free educational resources for clinicians on hepatitis B and hepatitis C. Learn about prevention, diagnosis and management via these links: http://bit.ly/2mjlMkz & https://bit.ly/3dBWvPY #GWCC #KnowHepB #KnowHepC | Download Image |
Message | Suggested Graphic |
---|---|
October is Liver Cancer Awareness Month. Did you know viral hepatitis B and C cause more than 60% of the most common form of liver cancer? Learn about viral hepatitis and liver cancer prevention at cdc.gov/hepatitis #GWCC #KnowHepB #KnowHepC | Download Image |
#Viral #hepatitis can cause #livercancer. Do you know if you or your loved ones should be tested? Learn about testing recommendation by visiting cdc.gov/hepatitis/hcv/guidelinesc #GWCC #KnowHepC | Download Image |
You’ve heard of hepatitis B and C, but do you know the important differences between these viral infections? Visit cdc.gov/hepatitis/resources/patientedmaterials to access fact sheets from CDC! #GWCC | Download Image |
#HepatitisB is common among Asian Americans, but most don’t know. Talk to a doctor about getting tested for hepatitis B if you or your parents were born in Asia or the Pacific Islands. Check out this fact sheet from cdc.gov/knowhepatitisb/PDFs/FactSheet-HepBAreYouAtRisk.pdf #GWCC #KnowHepB | Download Image |
Can you get #hepatitisC from casual contact with an infected person? No! It usually spreads when blood from a person infected with hepatitis C enters the body of someone who is not infected. Read more at cdc.gov/hepatitis/HCV/PDFs/HepCGeneralFactSheet.pdf #GWCC #KnowHepC | Download Image |
Among adults, men who have sex with men are at risk for hepatitis A and B. Learn more about how to protect yourself and talk to your doctor about getting vaccinated. Check out cdc.gov/hepatitis/populations/MSM-Vaccination | Download Image |
CDC is leading a national education campaign called “Know More Hepatitis” to decrease the burden of chronic viral hepatitis by increasing awareness and encouraging adults who may be infected to get tested. Check it out at cdc.gov/knowmorehepatitis #GWCC #KnowHepC | Download Image |
Did you know American Indian and Alaska Native communities are disproportionately affected by #hepatitisC infections? Get the facts at cdn.indiancountryecho.org #GWCC #KnowHepC | Download Image |
Some populations such as Hispanic/Latinx/a/o persons are largely affected by #viralhepatitis & #livercancer. Learn more about how you can prevent it at nuestrasvoces.org! #GWCC | Download Image |
Maintaining a healthy weight, avoiding excessive amounts of alcohol, getting vaccinated for #HepB and tested for #HepC are some ways to reduce the risk of liver cancer. Learn more during #LiverCancer Awareness Month at cdc.gov/cancer/liver #GWCC #KnowHepB #KnowHepC | Download Image |
Public health professionals, address viral hepatitis-related liver cancer through #PSE approaches. Read more at cdc.gov/hepatitis/policy #GWCC #livercancer | Download Image |
An estimated 41% of US adults have delayed or avoided medical care because of the #pandemic. Talk to your doctor about safely resuming viral hepatitis screening, care, and next steps. #GWCC #KnowHepB #KnowHepC #LiverCancerAwareness | Download Image |
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References
- Centers for Disease Control and Prevention. (2022, April 11). Hepatitis Awareness Month. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/hepatitis/awareness/HepatitisAwarenessMonth.htm
- American Association for Cancer Research. (n.d.). October is Liver Cancer Awareness Month. Retrieved from American Association for Cancer Research: https://www.aacr.org/patients-caregivers/awareness-months/liver-cancer-awareness-month/
- U.S. Cancer Statistics Working Group. (2022, June). U.S. Cancer Statistics Data Visualizations Tool, based on 2021 submission data (1999-2019). Retrieved from U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute: https://gis.cdc.gov/Cancer/USCS/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcancer%2Fdataviz%2Findex.htm#/AtAGlance/
- National Academies of Sciences. (2017). A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report. Washington, DC: The National Academies Press. Retrieved from https://nap.nationalacademies.org/catalog/24731/a-national-strategy-for-the-elimination-of-hepatitis-b-and-c
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- Centers for Disease Control and Prevention. (2022, February 16). Perinatal Transmission. Retrieved from https://www.cdc.gov/hepatitis/hbv/perinatalxmtn.htm
- National Cancer Institute. (2020). Cancer disparities. Retrieved August 11, 2021 from https://www.cancer.gov/about-cancer/understanding/disparities
- Jemal, A., Ward, E. M., Johnson, C. J., Cronin, K. A., Ma, J., Ryerson, B., Mariotto, A., Lake, A. J., Wilson, R., Sherman, R. L., Anderson, R. N., Henley, S. J., Kohler, B. A., Penberthy, L., Feuer, E. J., & Weir, H. K. (2017). Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival. Journal of the National Cancer Institute, 109(9), djx030. https://doi.org/10.1093/jnci/djx030
- White-Means, S., and Osmani, A. R. (2017). Racial and ethnic disparities in patient-provider communication with breast cancer patients: Evidence from 2011 MEPS and experiences with cancer supplement. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 1-17. https://doi.org/10.1177/0046958017727104
- Centers for Disease Control and Prevention (2021). About Social Determinants of Health (SDOH). Retrieved from https://www.cdc.gov/socialdeterminants/about.html
- Hepatitis B Foundation. (2022). Coalition Against Hepatitis for People of African Origin (CHIPO). Retrieved from https://www.hepb.org/research-and-programs/chipo/
- Centers for Disease Control and Prevention. (2020). Cancer Incidence Among African Americans, United States—2007–2016. USCS data brief, no 15. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2020. Retrieved from https://www.cdc.gov/cancer/uscs/about/data-briefs/no15-cancer-incidence-african-americans-2007-2016.htm
- Pomenti, S., Gandle, C., Abu Sbeih, H., Phipps, M., Livanos, A., Guo, A., Yeh, J., Burney, H., Liu, H., Dakhoul, L., Kettler, C., Gawrieh, S., deLemos, A., Scanga, A., Chalasani, N., Miller, E., & Wattacheril, J. (2020). Hepatocellular Carcinoma in Hispanic Patients: Trends and Outcomes in a Large United States Cohort. Hepatology Communications, 4(11), 1708–1716. https://doi.org/10.1002/hep4.1575
- American Society of Clinical Oncology. (2021, January). Liver Cancer: Screening. Retrieved from https://www.cancer.net/cancer-types/liver-cancer/screening#:~:text=Screening%20options%20for%20liver%20cancer,magnetic%20resonance%20imaging%20(MRI)
- Nuestras Voces. (n.d.). Protect Yourself Against Liver Cancer! Retrieved from https://www.nuestrasvoces.org/uploads/2/5/8/7/25879931/cancer_infographic_v2.12liver.pdf
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