Epidemiologic risk factors of hepatocellular carcinoma in a rural region of Egypt

Abstract

Background Hepatocellular carcinoma (HCC) is a major health problem worldwide, including Egypt. In the recent past, HCC has become the second most prevalent cancer among men in Egypt. Since HCC has not been well studied in the rural population of Egypt, this case-control study was conducted to investigate the epidemiologic risk factors of HCC in the predominantly rural region of Gharbiah, Egypt. Methods A total of 150 cases and 150 controls matched to cases on age (±5 years) and sex were recruited from the Gharbiah Cancer Society and Tanta Cancer Center. Exposure data were collected by an interviewer-administered standardized questionnaire about epidemiologic, occupational, medical and family history of HCC. Conditional logistic regression was utilized to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI). The effect modification of HCC risk between viral infection and environmental risk factors was also assessed.Results Being an industrial worker was an independent risk for developing HCC (OR 3.54, 95% CI 1.18, 10.63) after adjusting for viral infection, schistosomiasis and tobacco smoking. High relative risk of HCC was observed among HCV-infected individuals who were farmers (OR 9.60, 95% CI 3.72, 24.76), industrial workers (OR 12.90, 95% CI 4.33, 38.43) or active smokers (OR 5.95, 95% CI 2.20, 16.08). Conclusion Occupational exposure may play an important role in the development of HCC. Farming, industrial exposures and cigarette smoking may increase the risk of HCC among HCV-seropositive individuals. Future research focusing on mechanisms of occupational exposures among HCV patients in this population is needed.

Pesticide exposure and liver cancer: a review

“…Several studies ascertained occupation and industry information from a national supplemental pension fund, interviews, and questionnaires [44, 46, 50–52]. Some studies coded occupational information using classification systems such as the International Standard Classification of Occupations and the International Standard Industrial Classification of All Economic Activities [44, 46, 50].…”

“…Job titles were typically defined as farmer, farm worker, and farm laborer, and industries as agriculture. Although farming occupation was generally not associated with liver cancer [46, 50, 52], Schiefelbein et al (2012) showed farming vs. never employed in farming was associated with a statistically significant increased risk of HCC in Egypt (adjusted OR 2.8, 95% CI 1.1, 7.2), adjusting for HBV, anti-HCV, schistosomiasis, cirrhosis, and blood transfusion (controls were matched to cases according to age and sex) (Table 2) [51]. Pesticide exposure defined based on working in the agriculture industry in Denmark was not associated with liver cancer (Table 2) [44].…”

Circulating IL-6, IL-17 and vitamin D in hepatocellular carcinoma: Potential biomarkers for a more favorable prognosis?

“…Hepatitis C virus (HCV) infects primarily hepatocytes, leads to the development of fibrosis or cirrhosis of the liver, and is a significant risk factor for the development of HCC, in a process termed as 'inflammation-fibrosis-cancer axis' deaths. In Africa, HCC is the dominant type of liver cancer (Soliman et al, 2010). HCC is the second most frequent cause of cancer incidence and mortality among men in Egypt (Lehman and Wilson, 2009).…”

Research Training of Students in Minority and International Settings: Lessons Learned from Cancer Epidemiology Education in Special Populations

“…The publications highlight findings based on research with populations in the USA of Native Americans [4], Asian Indian women [5], and Arab Americans [6]. Published research from international settings also includes knowledge of human papilloma virus [7] and reliability of reproductive history recall among North African women [8]. Student publications in international training sites also have examined inflammatory breast cancer [9], bladder cancer [10], pancreatic adenocarcinoma [11], pediatric brain tumors [12], cervical cancer [13], and the concordance of plasma and tumor DNA methylation in hepatocellular carcinoma [14].…”