The chronic manifestations of hepatitis b drugs  significantly raise the risk of liver cirrhosis and liver cancer, making it a major public health issue. The World Health Organization (WHO) estimates that 296 million people worldwide have a chronic HBV infection as of 2019.

With the ultimate goal of eliminating viral hepatitis, the WHO 2030 target calls for a reduction in HBV-related deaths by 65 percent, an increase in treatment rates by 80 percent, and diagnostic coverage of 90 percent. China accounts for approximately one third of all infections worldwide, a disproportionately high burden. The country offers a screening program to specific demographic groups to help find cases that haven't been diagnosed. However, disease rates are still high, and in order to increase the rate of early diagnosis and treatment, a more extensive screening program is required.

Pregnant women, newborn infants, and blood donors are the only key target populations that are included in the current screening program. As part of a successful, state-funded vaccination program that began in 2002, infants in China receive vaccinations at birth. As a result, infant vaccination rates against hepatitis B are extremely high. However, the vast majority of adults are still unvaccinated, making them susceptible to infection. With two main effects, a universal screening program could identify more people earlier in life.

First, these people can start treatment earlier, lowering their risk of developing life-threatening conditions. This is especially true for the age group that may have been vaccinated against hepatitis B prior to 2002. Second, the number of annual incident cases may decrease in the coming years if people are aware of their disease status and take preventative measures to lower the risk of transmission. The risk of transmission to the unvaccinated population is high for individuals who are unaware of their infection status. Additionally, there is still the possibility of mother-to-child transmission, particularly in settings with limited resources.

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GlobalData epidemiologists say that by 2029, there will be more than 82.36 million total prevalent cases of HBV in China over the age of 15, including both diagnosed and undiagnosed cases. However, the current screening program will only result in a diagnosis for about 20% of these people. The cost-effectiveness of 180 universal screening strategies to reduce HBV-related mortality in China was evaluated in a recent study by Su and colleagues that was published in the Lancet Global Health. The study found that the most cost-effective screening method was a five-test approach, which had the potential to prevent 3.46 million deaths related to liver disease over the cohort's lifetime.

The study found, however, that the WHO 2030 goals to improve patient outcomes for diagnostics and treatment will probably not be achieved in China under the current screening guidelines. The country needs to look into ways to expand the current screening program because of the size of the diagnosis gap, the high prevalence of disease in the population, and the fact that there are effective treatment options.