In order to examine the association between hepatitis B virus carriage and hepatocellular carcinoma 3,769 female hepatitis B surface antigen positive blood donors were followed-up from 1977 to 1985 in Fukuoka, Japan. The observed number of deaths was compared with the expected deaths calculated by applying cause- and age-specific death rates among females for Fukuoka in 1980 to age-specific population at risk of the subjects. Mortalities from all causes and from all malignant neoplasms were decreased. Mortality from liver cancer (or hepatocellular carcinoma) was specifically elevated as compared with the general population; where observed, expected deaths, and O/E were 4, 0.71, and 5.63, respectively (p less than 0.05). Population attributable risk was estimated to be 6.5%. These values were assumed to be somewhat underestimated, in part because of a healthy donor effect and limited observation period.