Chronic hepatitis B or C infections are the most common risk factor for liver cancer.1 Together these diseases are estimated to cause up to 80% of liver cancers globally.2 Hepatitis B virus (HBV) is known to be a leading cause of liver cancer in Aboriginal and Torres Strait Islander people.3 Studies indicate that the risk of developing liver cancer can be 20-30 times higher in people with chronic hepatitis infection than among the general population.4
Charts
About this measure
In Australia, the collective prevalence of chronic hepatitis B and C is approximately 1% of the population,5,6 with a higher prevalence among Aboriginal and Torres Strait Islander people and people born in some other countries, as in Asia and the Pacific.7 Hepatitis B virus (HBV) is a leading cause of liver cancer in the Aboriginal and Torres Strait Islander population.3 Between 2011 and 2015, there were 234 new diagnoses of liver cancer were notified in Aboriginal and Torres Strait Islander people (i.e., about 47 new cases a year), and 235 deaths from liver cancer in the period 2014–2018 (i.e., about 47 deaths a year).8
There are effective vaccines available for hepatitis B in Australia, with hepatitis B vaccines being provided free-of-charge since 2000 for vaccination of infants. Vaccinations are provided under the National Immunisation Program Schedule;9 doses are administered to infants soon after birth, followed by doses at two, four and six months of age. ‘Immunisation coverage’ is defined as the percentage of children notified to the Australian Immunisation Register (AIR) as having received three doses of hepatitis B vaccine at a designated age (i.e., at 24 -27 months).10
For a comparison with vaccination of the broader Australian community, see the NCCI ‘Hepatitis B immunisation’.
Current status
Hepatitis B immunisation coverage is very high (about 97% in 2018) among Aboriginal and Torres Strait Islander children aged 24-27 months.3
Trends
Since 2014, hepatitis B immunisation coverage for Aboriginal and Torres Strait Islander children has remained consistently high at about 95% or higher. This may be due to the introduction of the universal infant immunisation program9 in 2000, which likely had a positive impact on the population coverage.11
From 2014 to 2018, hepatitis B immunisation among Aboriginal and Torres Strait Islander children aged 24-27 months increased from 95.1% to 97.1%.3
About the data
This measure shows the proportion of Aboriginal and Torres Strait Islander children aged 24 to 27 months who have been notified to the Australian Immunisation Register (AIR) as having received three doses of any hepatitis B vaccine. A three-month lag period (i.e., from 24 to 27 months) is allowed for late notifications to the AIR. The cohort method has been used for calculating immunisation coverage at the population level (refer to Reference 10 for more information).
Numerator: Children aged 24 to 27 months who have been notified to the Australian Immunisation Register (AIR) as having received three doses of hepatitis B vaccine.
Denominator: Total number of Medicare-registered children aged 24 months.
Data sources:
Australian data are sourced from the AIR. Participation in the AIR is based on an “opt-out process” which has achieved close to complete population coverage.10
Analyses of AIR data are presented in Communicable Diseases Intelligence reports.12 Data are also published in annual immunisation coverage reports by the National Centre for Immunisation Research & Surveillance13 and annual reports published by the Kirby Institute on The National update on HIV, viral hepatitis and sexually transmissible infections in Australia,3 these reports have been used as the primary sources for this indicator.
References
Activity in this area
Data:
Australian Government Department of Health. About Communicable Diseases Intelligence. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-cdi-cdiintro.htm
The Kirby Institute: Aboriginal Surveillance Reports. Available from: https://kirby.unsw.edu.au/report-type/aboriginal-surveillance-reports
Policy:
Immunise Australia Program. Available from: https://beta.health.gov.au/health-topics/immunisation
Australian Government Department of Health. Immunisation for Aboriginal and Torres Strait Islander people. Available from: https://www.health.gov.au/health-topics/immunisation/immunisation-throughout-life/immunisation-for-aboriginal-and-torres-strait-islander-people
Australian Government Department of Health. Third National Hepatitis B Strategy 2018-2022. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-bbvs-1//$File/Hep-B-Third-Nat-Strategy-2018-22.pdf
Cancer Australia. National Aboriginal and Torres Strait Islander Cancer Framework. 2015. Available from: https://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/overlay-context=affected-cancer/aboriginal-and-torres-strait-islander-people/national-aboriginal-and-torres-strait-islander-cancer-framework
Cancer Australia. Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer. 2018 Available from: https://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/optimal-care-pathway-aboriginal-and-torres-strait-islander-people-cancer
References
1. American Cancer Society 2014. Liver Cancer. Available from: https://www.cancer.org/cancer/liver-cancer/causes-risks-prevention/risk-factors.html (accessed December 2021).
2. Cancer Council Victoria. Hepatitis B & liver cancer. Available from: www.cancervic.org.au/for-health-professionals/community-health-professionals/hepatitis-b-and-liver-cancer (accessed December 2021).
3. National update on HIV, viral hepatitis and sexually transmissible infections in Australia: 2009–2018. Sydney: Kirby Institute, UNSW Sydney; 2020. Available from: https://kirby.unsw.edu.au/sites/default/files/kirby/report/National-update-on-HIV-viral-hepatitis-and-STIs-2009-2018.pdf (accessed January 2022).
4. Amin J et al. Cancer incidence in people with hepatitis B or C infection: a large community-based linkage study. J Hepatol 2006;45(2):197-203.
5. Antonsson A et. al. Cancers in Australia in 2010 attributable to infectious agents. Aust NZ J Public Health. 2015; 39:446-51.
6. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016. The Kirby Institute, UNSW: Sydney, Australia, 2016.
7. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia, Annual surveillance report 2018. The Kirby Institute, UNSW: Sydney, Australia, 2018.
8. Australian Institute of Health and Welfare. Cancer in Australia, 2021. Available from: https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/summary (accessed December 2021)
9. Immunise Australia Program 2021. National Immunisation Program Schedule. Available from: https://beta.health.gov.au/topics/immunisation/immunisation-throughout-life/national-immunisation-program-schedule (accessed December 2021).
10. National Centre for Immunisation Research & Surveillance 2021. Annual Immunisation Coverage Report 2020.
11. The Kirby Institute. Bloodborne viral and sexually transmissible infections in Aboriginal and Torres Strait Islander people: annual surveillance report 2018. The Kirby Institute, UNSW: Sydney, Australia, 2018.
12. Australian Government Department of Health. About Communicable Diseases Intelligence. http://www.health.gov.au/internet/main/publishing.nsf/Content/cda-pubs-cdi-cdiintro.htm (accessed December 2021).
13. NCIRS. Immunisation coverage. http://www.ncirs.edu.au/surveillance/immunisation-coverage/ (accessed December 2021).