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Article: Changing pattern of hepatocellular carcinoma (HCC) and its risk factors in Egypt: Possibilities for prevention

TitleChanging pattern of hepatocellular carcinoma (HCC) and its risk factors in Egypt: Possibilities for prevention
Authors
Issue Date2008
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/mutrev
Citation
Mutation Research - Reviews In Mutation Research, 2008, v. 659 n. 1-2, p. 176-184 How to Cite?
AbstractThe burden of hepatocellular carcinoma (HCC) has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. This has been attributed to several biological (e.g. hepatitis B and C virus infection) and environmental factors (e.g. aflatoxin, AF). Other factors such as cigarette smoking, occupational exposure to chemicals such as pesticides, and endemic infections in the community, such as schistosomiasis, may have additional roles in the etiology or progression of the disease. Estimates of the burden of cancer caused by these factors provide an opportunity for prevention. Previously, there was strong evidence that hepatitis B virus (HBV) was the major cause of HCC in Egypt, but more recently HCV has become the predominant factor associated with the more recent epidemic of HCC. It has been well documented that Egypt has one of the highest prevalence rates of HCV infection in the world. The natural history of HCV infection and disease progression, however, are influenced by additional factors such as duration of infection, age at infection, sex, co-infection with HBV, the level of HCV viraemia and its genotype. The role of exposure to aflatoxins and development of HCC in Egypt was historically less clear. Nevertheless, recent food sampling surveys and population-based studies indicated that exposure to aflatoxins in Egypt may have been underestimated in the past. Recent results indicated that both local and imported samples were positive for aflatoxin B1 (AFB1, 17.5% and 20%, respectively), with concentrations ranging from 3 to 25 μg/kg. The level of AFB1 was dependent on the area of collection as well as the season of the year. In a population-based study, the level and frequency of aflatoxin M1 (AFM1, a major metabolite of aflatoxin B1 excreted in breast milk) was assessed as a biomarker of maternal exposure. The samples were collected from a selected group of 388 Egyptian lactating mothers during May-September 2003. Non-working status, obesity, high corn oil consumption, and the number of offspring contributed to the variability in occurrence of AFM1 in breast milk. Prevention and intervention approaches directed to risk factors of HCC can play a critical role in its prevention. In the case of HCV infection a prevention programme can be achieved by changing personal behaviors and/or cultural habits which are risk factors for HCV transmission, such as injection with contaminated syringes, blood transfusion, surgical operations, venous catheterization, use of common syringes, dental treatment and circumcision at home. Prevention of exposure to aflatoxins can be achieved either at community (via good agriculture practices) or individual levels (treatment or dietary interventions). In conclusion, due to the alarming increase in the incidence of HCC in Egypt, there is a need to further investigate the contribution of these emerging risk factors to the development of HCC in Egypt. This may enable us to determine the susceptibility to HCC among high-risk groups and to provide these individuals with effective measures for early prevention or intervention. © 2008 Elsevier B.V. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/60635
ISSN
2015 Impact Factor: 5.261
2015 SCImago Journal Rankings: 2.494
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorAnwar, WAen_HK
dc.contributor.authorKhaled, HMen_HK
dc.contributor.authorAmra, HAen_HK
dc.contributor.authorElNezami, Hen_HK
dc.contributor.authorLoffredo, CAen_HK
dc.date.accessioned2010-05-31T04:15:33Z-
dc.date.available2010-05-31T04:15:33Z-
dc.date.issued2008en_HK
dc.identifier.citationMutation Research - Reviews In Mutation Research, 2008, v. 659 n. 1-2, p. 176-184en_HK
dc.identifier.issn1383-5742en_HK
dc.identifier.urihttp://hdl.handle.net/10722/60635-
dc.description.abstractThe burden of hepatocellular carcinoma (HCC) has been increasing in Egypt with a doubling in the incidence rate in the past 10 years. This has been attributed to several biological (e.g. hepatitis B and C virus infection) and environmental factors (e.g. aflatoxin, AF). Other factors such as cigarette smoking, occupational exposure to chemicals such as pesticides, and endemic infections in the community, such as schistosomiasis, may have additional roles in the etiology or progression of the disease. Estimates of the burden of cancer caused by these factors provide an opportunity for prevention. Previously, there was strong evidence that hepatitis B virus (HBV) was the major cause of HCC in Egypt, but more recently HCV has become the predominant factor associated with the more recent epidemic of HCC. It has been well documented that Egypt has one of the highest prevalence rates of HCV infection in the world. The natural history of HCV infection and disease progression, however, are influenced by additional factors such as duration of infection, age at infection, sex, co-infection with HBV, the level of HCV viraemia and its genotype. The role of exposure to aflatoxins and development of HCC in Egypt was historically less clear. Nevertheless, recent food sampling surveys and population-based studies indicated that exposure to aflatoxins in Egypt may have been underestimated in the past. Recent results indicated that both local and imported samples were positive for aflatoxin B1 (AFB1, 17.5% and 20%, respectively), with concentrations ranging from 3 to 25 μg/kg. The level of AFB1 was dependent on the area of collection as well as the season of the year. In a population-based study, the level and frequency of aflatoxin M1 (AFM1, a major metabolite of aflatoxin B1 excreted in breast milk) was assessed as a biomarker of maternal exposure. The samples were collected from a selected group of 388 Egyptian lactating mothers during May-September 2003. Non-working status, obesity, high corn oil consumption, and the number of offspring contributed to the variability in occurrence of AFM1 in breast milk. Prevention and intervention approaches directed to risk factors of HCC can play a critical role in its prevention. In the case of HCV infection a prevention programme can be achieved by changing personal behaviors and/or cultural habits which are risk factors for HCV transmission, such as injection with contaminated syringes, blood transfusion, surgical operations, venous catheterization, use of common syringes, dental treatment and circumcision at home. Prevention of exposure to aflatoxins can be achieved either at community (via good agriculture practices) or individual levels (treatment or dietary interventions). In conclusion, due to the alarming increase in the incidence of HCC in Egypt, there is a need to further investigate the contribution of these emerging risk factors to the development of HCC in Egypt. This may enable us to determine the susceptibility to HCC among high-risk groups and to provide these individuals with effective measures for early prevention or intervention. © 2008 Elsevier B.V. All rights reserved.en_HK
dc.languageengen_HK
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/mutreven_HK
dc.relation.ispartofMutation Research - Reviews in Mutation Researchen_HK
dc.subject.meshAflatoxins - toxicityen_HK
dc.subject.meshCarcinoma, Hepatocellular - epidemiology - prevention & controlen_HK
dc.subject.meshEgypt - epidemiologyen_HK
dc.subject.meshHepatitis, Viral, Human - complicationsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLiver Neoplasms - epidemiology - prevention & controlen_HK
dc.subject.meshPesticides - toxicityen_HK
dc.subject.meshPublic Healthen_HK
dc.subject.meshRisk Factorsen_HK
dc.titleChanging pattern of hepatocellular carcinoma (HCC) and its risk factors in Egypt: Possibilities for preventionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0027-5107 &volume=659&spage=176&epage=84&date=2008&atitle=Changing+pattern+of+hepatocellular+carcinoma+(HCC)+and+its+risk+factors+in+Egypt:+possibilities+for+prevention.en_HK
dc.identifier.emailElNezami, H: elnezami@hkucc.hku.hken_HK
dc.identifier.authorityElNezami, H=rp00694en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.mrrev.2008.01.005en_HK
dc.identifier.pmid18346933-
dc.identifier.scopuseid_2-s2.0-47849123987en_HK
dc.identifier.hkuros151550en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-47849123987&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume659en_HK
dc.identifier.issue1-2en_HK
dc.identifier.spage176en_HK
dc.identifier.epage184en_HK
dc.identifier.isiWOS:000258811000021-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridAnwar, WA=7004253805en_HK
dc.identifier.scopusauthoridKhaled, HM=7003807559en_HK
dc.identifier.scopusauthoridAmra, HA=14014308000en_HK
dc.identifier.scopusauthoridElNezami, H=6603690577en_HK
dc.identifier.scopusauthoridLoffredo, CA=35473279900en_HK

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