Samuel So, MBBS, FACS Lui Hac Minh Professor Professor of Surgery Founder and Director, Asian Liver Center Stanford University School of Medicine

Transcription

1 Samuel So, MBBS, FACS Lui Hac Minh Professor Professor of Surgery Founder and Director, Asian Liver Center Stanford University School of Medicine APPEAL, San Francisco, Sept 25, 2014

2 Asian patients were dying from liver cirrhosis and liver cancer because they Don t know about the seriousness of hepatitis B Were not tested Did not get liver cancer screening when infected Doctors Did not screen or know how to screen for hep B Don t know how to care for patients with chronic hepb Government agencies No initiatives to raise awareness or educate No resources for screening

3 Dr. Mark Lim Internist Healthy hepatitis B carrier Diagnosed with advanced liver cancer at 31years of age Died before 32nd birthday Engardio. San Francisco Chronicle, 2003

4 Founded in 1996 First non-profit organization established to address the disproportionately high incidence of HBV and liver cancer in Asians and Asian Americans (funded by donations, foundations and federal grants) Goal: eliminate HBV transmission, stigma and complications, and reduce the incidence and mortality of HCC worldwide Four-pronged approach to address the gaps C - collaboration (public and private) A - advocacy (policy makers) R - research (liver cancer prevention and treatment) E - education (public, healthcare providers, policy makers)

5 2010 U.S. Institute of Medicine Report Found the Major Hurdle in Hepatitis Prevention and Control in the U.S. Morbidity and Mortality related to hepatitis B and hepatitis C Lack of Public Awareness Lack of Provider Awareness Lack of Public Resource Allocation

6 Chronic HBV Infection is a Common Liver Disease in Asians in the U.S. Racial/Ethnic Population Prevalence of Chronic HBV Infection Asian and Pacific Islander (foreign born) 1 in 12 Asian and Pacific Islander (US born) 1 in 70 African American 1 in 200 Hispanic 1 in 1,100 Non-Hispanic White 1 in 800 Asian Americans make up 5% of the U.S. Population, but over 50% of those in the U.S. with chronic HBV infection. Two-thirds are not aware of their disease. Source: CDC draft ACIP recommendations, 2005

7 10 Most Common Causes of Cancer Death in US Men White men 1. Lung and bronchus 2. Prostate 3. Colon and rectum 4. Pancreas 5. Leukemia 6. Non-Hodgkin lymphoma 7. Urinary bladder 8. Esophagus 9. Liver 10. Kidney API men 1. Lung and bronchus 2. Liver 3. Colon and rectum 4. Prostate 5. Stomach 6. Pancreas 7. Non-Hodgkin lymphoma 8. Leukemia 9. Esophagus 10. Kidney US Cancer Statistics: Incidence and Mortality Web-based Report. Available at cdc.gov/uscs

8 Jade Ribbon Launched in 2001 as a universal symbol to raise awareness about HBV and liver cancer and support those living with hepatitis B Jade = Good health and longevity #joinjade

9 Jade Ribbon: Five Key Messages Get informed Get tested Get vaccinated if unprotected Get care and screen for liver cancer if chronically infected Wear the Jade Ribbon, tell your friends and family Chao S, So S, J Commun Healthcare 2011, 4:46-55

10 JR: Reaching out to At Risk Population to Increase Awareness Moon Festival Miss Asian American Pageant Dragon Boat Race Community Health Fair Tet Festival Chinese New Year Street Festival and Parade

11 JR: Partner with Community Organizations to Educate the At Risk Population and Healthcare Providers (including TCM practitioners) Chang ET et al. J Altern Complement Med 2007

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13 JR: Partner with Community Groups and Health Depts to offer Free Hepatitis B Screening

14 JR: Engaging the Media to Raise National Awareness

15 Asian Liver Center s Public Service Announcements and Documentaries

16 Hep B Free: City and County-wide Jade Ribbon Campaigns

17 JR: Inspire Youths to Become Hepatitis B 11 th Annual Youth Leadership Conference, Aug 2013 Ambassadors Brown Cornell DeAnza Harvard MIT New York City Northwestern Rice Rutgers San Jose State Stanford U Illinois, Urban U of Chicago U of Nevada U Washington UC Berkeley UC Davis UC Los Angeles UC Riverside UC San Diego U Pacific Wingate

18 ALC: Spearheads efforts leading to Changes in U.S. Policies to Address the Gaps in HBV Prevention and Control 2008, Office of Minority Health recognized chronic HBV infection in API as a serious neglected national health disparity 2010, Institute of Medicine report on a national strategy on prevention and control of hepatitis 2011, DHHS released the national action plan for prevention, care and treatment of viral hepatitis 2014, USPSTP recommends hepatitis B screening of foreign born from endemic countries

19 ALC: Spearheads Advocacy to Increase Resources for National and Global Hepatitis Prevention and Treatment Partner with legislators: Congressman Honda: Hepatitis and Liver Cancer Bills introduced in Congress (2005, HR 4450, 2009, HR 3974) and Senate (2010) Assemblywoman Fiona Ma: 2010 Resolution passed by state of California to recognize Hepatitis Awareness week in May Advocate for resources to support global prevention and treatment

20 EMPLOYER HEPATITIS B CHECKLIST (yucorps.org) Review healthcare coverage Eliminate discriminatory policies Educate employees Offer onsite screening Offer onsite vaccination Offer offsite vaccination reimbursement

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