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. 2011 Apr 7;6(4):e18415.
doi: 10.1371/journal.pone.0018415.

Increase in female liver cancer in the Gambia, West Africa: evidence from 19 years of population-based cancer registration (1988-2006)

Dominique Sighoko  1 , Maria Paula Curado, Denis Bourgeois, Maimuna Mendy, Pierre Hainaut, Ebrima Bah
Affiliations

Increase in female liver cancer in the Gambia, West Africa: evidence from 19 years of population-based cancer registration (1988-2006)

Dominique Sighoko et al. PLoS One. .

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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Liver cancer incidence rates per 100000 Gambians by 5-years age groups.
Data from the Gambia National Cancer Registry, 1998–2006.
Figure 2
Figure 2. Male comparative liver cancer trends over two periods of 10 (1988–1997) and 9 (1998–2006) years, by age group.
Figure 3
Figure 3. Female comparative liver cancer trends over two periods of 10 (1988–1997) and 9 (1998–2006) years, by age group.
See this image and copyright information in PMC

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