Up to 80 per cent of liver cancers worldwide are caused by Hepatitis B (Hep B), which causes inflammation of the liver, according to the World Health Organisation (WHO).

Liver cancer is the third most common cancer among Singaporean men, coming after cancers of the lung and colon. Men are three times as likely to get liver cancer than women, though it is unknown why this is so.

Between 1998 and 2002, 1,855 primary liver cancers were diagnosed here. Yet, more than half of Singaporeans aged 30 to 74 years have no immunity to the Hep B virus - the main cause of liver cancer in Asia - though a vaccine is readily available.

The danger of Hep B is that those infected with it may not show any symptoms. If they do, the symptoms are often flu-like - for eg, fever, nausea and vomitting, poor appetite - and hence not recognised as symptoms of a serious condition. If the infection is not treated, it may develop into acute hepatitis (episode of liver inflammation), chronic hepatitis (permanent liver inflammation), liver cirrhosis (permanent scarring and hardening), liver failure or liver cancer.

And the problem with liver cancer is that its symptoms, which include abdominal pain and swelling, jaundice and loss of appetite, usually appear only in the later stages when the tumour is large and liver function is already impaired.

Liver cancer impacts on major functions of the body, including digestion of food, detoxification of poisonous substances, metabolism and storage of energy. It is almost always fatal.

For those who get Hep B, they become immune to the disease if they recover. One in 10 will become carriers, however, which means the virus stays permanently in the body. According to Singapore's Health Promotion Board (HPB), one in 35 adult Singaporeans are carriers.

Hep B carrriers seldom show any symptoms as well, and may eventually develop the severe liver conditions mentioned above or unknowingly spread it to others. The virus is spread via contact with blood or bodily fluids of an infected person, either through cuts or sores in the mouth or on the skin, or through sexual contact.

Carriers have to contend with a lifetime of regular health checks - at least once a year - to check their liver function. Yet, three injections over a half-year period are all that are needed to prevent all these problems - the message the HPB is trying to put across in its current awareness campaign

The month-long campaign aims to reach out to those - mainly adults - who have not been immunised under the national Hep B infant immunisation programme, introduced from Sept 1, 1987, and the catch-up immunisation programmes in Jan 2001 for post-primary school students and those in National Service.

A 2005 survey by the Ministry of Health showed that 59.3 per cent of the population aged 30 to 74 years and 57.2 per cent aged 30 to 44 years were not immune to the Hep B virus.

According to the WHO, the vaccine is 95 per cent effective in preventing chronic Hep B in children and adults, provided they have not been infected. It costs about $50 for three doses of the vaccine.

The last public campaign for Hep B awareness took place in 2003. "Despite this widespread campaign, more than half of the adult population is still not immunized against Hep B," said the HPB.

"More adults need to learn about the benefits of the Hep B vaccine especially with regards to lowering their risk of liver cancer," it said.

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To find out more:

There will be a public forum tomorrow from 2.30pm to 5pm on ?Hepatitis B and its link to Liver Cancer? at the Kwong Wai Shiu Hospital. The forum is held by the National Cancer Centre with support by the HPB.

For more information on this forum, please call 6297 6250 / 6294 6592