STEVE INSKEEP, host:
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A quirk of demographics has affected the health of San Francisco. The city has the highest rate of liver cancer in the country. Turns out the high rate of cancer is linked to the high rate of chronic hepatitis B infection and that is concentrated in a particular group - immigrants from Asia. Now, other cities with Asian immigrants are watching the way that San Francisco tries to spread a vaccine and treatment. Sarah Varney reports from member station KQED.
SARAH VARNEY: At the Asian Heritage Street Fair in front of San Francisco's glittering City Hall, television anchor man Alan Wang takes the microphone on the main stage.
Mr. ALAN WANG (Anchor man): By day, I'm an anchor man with ABC 7 news, but when people are in danger...
(Soundbite of Superman theme song)
VARNEY: Wang slowly, seductively unbuttons his shirt revealing a Superman logo with the letter "B" part of the city's campaign urging residents to get tested for hepatitis B.
Mr. WANG: That's right. I'm a hero, too.
VARNEY: Hepatitis B attacks the liver and can lead to cancer. The virus may have originated in Asia centuries ago, and it's been passed down from infected mothers to their newborn infants ever since. Many of those Asian parents and children immigrated here to San Francisco, where one-third of the city's population is of Asian descent.
Mr. WANG: I have hepatitis B, my brothers and sisters do. By talking about it, you take away the stigma. I'm not a drug user. I'm not a prostitute. In fact, most of the people who carry hepatitis B are like me, and so we're here to encourage you just to get tested.
VARNEY: The hep B virus can be detected by a blood test. But typically U.S. physicians only test patients who engage in risky behaviors like intravenous drug use or unprotected sex. That's because the virus is spread through infected blood and bodily fluids.
A recent Institute of Medicine report concluded that doctors aren't aware that Asian immigrants, especially those from China, are much more likely to have been infected at birth.
Unidentified Woman: Now, we're also doing free hepatitis B screenings over here. So if you haven't done it yet. It's free. It's fast. They'll mail the results right to your home.
VARNEY: San Francisco public health officials are trying to raise awareness of the issue. As part of an aggressive campaign to stem hep B infections, the city is offering free testing, vaccination and treatment to all residents, young and old.
Unidentified Man #1: You're just going to feel a little pinch on three. One, two and three.
VARNEY: Albert Ng wondered into a testing booth at the Asian Heritage street fair. He's 30 years old. And even though his Chinese grandfather died of liver cancer caused by the virus, it's the first time he's ever been tested for hep B.
Mr. ALBERT NG: In the Asian-American family, usually parents don't want to discuss if they have diseases. So we tend to discuss the good stuff, but never discuss the weaknesses.
VARNEY: That reluctance has been a big challenge for public health officials in San Francisco. After launching an upbeat public awareness campaign three years ago, the city recently unveiled a much darker approach. The ads feature statuesque Asian beauty queens, meant to provoke residents into action.
Unidentified Man #2: (Through translator): Of all these young women, which one deserves to die? One in ten Asian Americans is infected with hepatitis B, the leading cause of liver cancer.
VARNEY: Getting tested is critical, public health officials say, because many people who are chronically infected feel no symptoms. If caught early enough, the virus can be suppressed with medication. But if left untreated, about one in four will develop liver cancer, which is often fatal.
Dr. SAMUEL SO (Director, Asian Liver Center, Stanford University): This is a disease which, unlike HIV, we have all the solutions.
VARNEY: Dr. Samuel So directs the Asian Liver Center at Stanford University. He says state and federal health officials need to bring more money and attention to the disease.
Dr. SO: We know how to prevent it. We have a very effective vaccine; we have treatments which can help to suppress the virus. And yet we are not doing a good job.
VARNEY: The San Francisco effort is an important start, says Dr. So. Indeed, a handful of other cities including Los Angeles and Philadelphia plan to replicate the program.
But until there is a more aggressive national campaign to control chronic infection, people like anchorman Alan Wang will sell the message of hep B in anyway they can even if it means a Superman-inspired striptease in front of City Hall.
For NPR News, I'm Sarah Varney.
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