The incidence of primary liver cancer (PLC) varies widely in different areas of the world. It is an important disease in India, in the Far East, and especially in parts of subsaharan Africa. Although seldom seen in Europe and in America, the estimated incidence is three per 10,000 in Senegal where the present study was made. It accounts for 24% of all cancer in men and 5% in women, while in Europe this proportion does not exceed 1% to 3% according to the most recent statistics, standardized for age.1
The cause(s) of PLC that might explain this special geographic distribution remain unknown. Several hypotheses have been advanced. Malnutrition has few supporters, while genetic predisposition possibly would have only a contributing effect. The most popular hypothesis is that food contains hepatocarcinogenic substances, such as cycasin, pyrolizidine alkaloids, and especially aflatoxin.2 Some investigators have advanced an oncogenic role for the
Masseyeff R, Prince AM, Leblanc L, Szmuness W. Detection of HAA in the Serum of Patients With Primary Carcinoma of the Liver. Am J Dis Child. 1972;123(4):412–413. doi:10.1001/archpedi.1972.02110100144055
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