Understanding Hepatitis B and Liver Cancer Knowledge and Testing Among Different Communities

Hi all! This is Chari from the Hepatitis B Foundation. Since 2020, we have been working on a project to better understand knowledge and misperceptions of liver cancer risk among communities that are highly impacted by hepatitis B. We want to better understand how people think about the link between hepatitis B and liver cancer, and how we can use what we learn to develop better education and health communication programs globally.

We conducted 15 focus groups and some interviews with people living in the U.S. who were from diverse communities (who had immigrated from other places): People from China, Vietnam, Korea, Haiti, Senegal, Mali, Niger, Nigeria, Somalia, Micronesia, Ethiopia, Philippines, Hmong, Burkina Faso.

We learned that overall, there is low awareness about the link between hepatitis B and liver cancer. For the most part, communities think of hepatitis B separately from liver cancer. Many people in the focus groups felt that if we did a better job of helping people make the link between hepatitis B and liver cancer, people might be more likely to get tested for hepatitis B, and to seek or stay in medical care if they have hepatitis B.

We also saw many differences between groups, in terms of how they want to learn about health information - but some similarities. We asked the focus group participants how they would want to learn about the link between hepatitis B and liver cancer, and what types of messages would work best in their community. All participants felt that messages should be hopeful and optimistic, while also showing statistics to help people understand the risk. All participants had specific cultural norms that need to be followed in terms of health messaging - including being careful about discussing sexual transmission, and not discussing death or mortality. Most participants felt that health education strategies needed to be focused towards older and younger generations separately - that older generations like to learn more from written materials, newspapers, and in-language - and that younger generations like to learn more from social media and using technology.

We are in the process of publishing the details of what we did and what we learned. We have three papers we are currently writing and submitted to journals. We are also using what we learned to develop cultural and language specific health communications campaigns that we hope to launch in 2024. We are working with people from diverse communities to help develop and get feedback on our materials.

We know that overall, there is know awareness and knowledge about hepatitis B globally. We want to improve awareness and knowledge to help create more conversation and prioritization around hepatitis B, as we work towards elimination. We hope that ultimately, what we are doing will help more people better understand the link between hepatitis B and liver cancer. We think that this will help communities have better and more informed discussions about hepatitis B, and can help promote sustainable care and treatment in some communities.

I look forward to hearing feedback, and thanks for listening!


Hi Chari

That’s the thing about
HepB . It can lead to liver cancer.And nobody knows.
I have two ideas.

  1. Screen immigrants
  2. TV advertising



Hi Caraline. I agree - it is challenging that so few people know that hepatitis B can lead to liver cancer, and that testing and medical management/treatment can help prevent it from happening. I agree that we need to greatly increase screening - I would actually like to see universal screening sometime soon around the world. If we screen everyone, the way we do with other common illnesses, we would be able to diagnose millions more people. Of course, we would also need to make sure we are able to get everyone diagnosed into health care and access to treatment - and we need to address discrimination before we propose such universal screening. But it would the simplest way to diagnose people without stigmatizing any specific groups.

I also agree about the TV advertising. Our research shows that many groups like to learn health information through radio and TV - and we all know that TV and radio are a great way to reach millions of people. I wish we had enough funds to do this! Radio and TV are expensive - definitely something that nonprofit organizations couldn’t afford. But industry partners, governments, large foundations and other funders might be interested in funding large-scale TV and radio ads - like they do for hepatitis C and HIV in the U.S.

Thanks for your ideas, they are great!