Beasley’s 1981 paper: The power of a well-designed cohort study to drive liver cancer research and prevention

•Beasley, et al., demonstrated chronic hepatitis B virus (HBV) infection precedes hepatocellular carcinoma (HCC) development.•The results facilitated the implementation of liver cancer prevention programs, particularly through HBV vaccination.•The study took advantage of existing systems to prospectively evaluate HBV and HCC through a well-designed cohort study.•This effort led to team-science to evaluate the impact of HBV vaccination and natural history of HBV infection in Taiwan. The 1981 Lancet paper by Beasley et al., “Hepatocellular carcinoma and hepatitis B virus. A prospective study of 22707 men in Taiwan” is a seminal publication that clearly demonstrated that chronic infection with hepatitis B virus (HBV), as measured by seropositivity for the hepatitis B surface antigen (HBsAg), preceded the development of hepatocellular carcinoma (HCC). In doing so, this study paved the way for liver cancer prevention efforts through the implementation of hepatitis B vaccination programs. In this commentary, we will describe the discovery of HBV, which led to the study by Beasley et al.; summarize the major findings of the Beasley paper and its implications; discuss the importance of well-designed cohort studies for prevention activities; and consider the ramifications of the Beasley study and the work that has followed since.