Hepatitis B testing for liver cancer control among Korean Americans.

INTRODUCTION In Los Angeles County, Koreans surpass all other groups with respect to liver cancer incidence and mortality. An estimated 80%-85% of all liver cancer is etiologically related to chronic hepatitis B viral infection. Hepatitis B serologic testing of adult immigrants from highly endemic areas such as Asia is recommended as the first step in the control of hepatitis B infection and associated morbidities including liver cancer. OBJECTIVE To collect pilot data to obtain an initial understanding of hepatitis B serologic testing and vaccination rates and associated knowledge and beliefs in a community sample of Korean adults (N=141, 85% foreign born, mean age 45 years) in the greater Los Angeles area. DESIGN Cross-sectional survey. SETTING Five Korean Christian churches and one Korean-serving primary care clinic. RESULTS The hepatitis B serologic testing rate in our sample was 56%. Approximately one quarter of those tested reported that they were either chronic carriers or were immune as a result of a previous infection. Of those who remained susceptible to future infections, only 38% reported having been vaccinated. Constructs from our conceptual model, the Health Behavior Framework, were significant predictors of serologic testing, including hepatitis B knowledge, barriers to testing, and receipt of a physician's recommendation to get tested. CONCLUSION Findings suggest that intervention research is urgently needed to increase hepatitis B awareness and testing among Korean American adults with subsequent vaccination and followup as indicated.