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Increase in Female Liver Cancer in The Gambia, West Africa: Evidence from 19 Years of Population-Based Cancer Registration (1988–2006)

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  • Dominique Sighoko
  • Maria Paula Curado
  • Denis Bourgeois
  • Maimuna Mendy
  • Pierre Hainaut
  • Ebrima Bah

Abstract

Background: Hepatocellular Carcinoma (HCC) is a common malignancy worldwide with a high burden in West Africa. Male to female ratios show consistent bias toward males, the biological bases and variations of which are not well understood. We have used data from the Gambian National Cancer Registry to compare trends in incidence of HCC in both genders. Methods and Findings: Two periods were compared, 1988–1997 (early) and 1998–2006 (recent). In addition, the regression program joinpoint was used to assess trends over 19 years. Differences with self-reported ethnicity were assessed for the recent period using population data from 2003 census. Male to female ratio showed a significant decrease between the two periods from 3.28∶1 (95% CI, [2.93–3.65]) to 2.2∶1 (95% CI, [1.99–2.43]). Although rates in males were relatively stable (38.36 and 32.84 for, respectively, early and recent periods), they increased from 11.71 to 14.9 in females with a significant Annual Percentage Change of 3.01 [0.3–5.8] over 19 years and an increase in number of cases of 80.28% (compared to 26% in males). Significant variations in HCC risk, but not in gender ratio were observed in relation with ethnicity. Conclusion: This analysis of the only national, population-based cancer registry in West Africa shows a significant increase in HCC in females over recent years. This increase may be the consequence of major changes in lifestyle or viral risk factors, in particular obesity and hepatitis C, which have both been documented to increase in West Africa during recent years.

Suggested Citation

  • Dominique Sighoko & Maria Paula Curado & Denis Bourgeois & Maimuna Mendy & Pierre Hainaut & Ebrima Bah, 2011. "Increase in Female Liver Cancer in The Gambia, West Africa: Evidence from 19 Years of Population-Based Cancer Registration (1988–2006)," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-7, April.
    • Handle: RePEc:plo:pone00:0018415
    DOI: 10.1371/journal.pone.0018415
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    References listed on IDEAS

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    1. Pampel, Fred, 2008. "Tobacco use in sub-Sahara Africa: Estimates from the demographic health surveys," Social Science & Medicine, Elsevier, vol. 66(8), pages 1772-1783, April.
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