Dietary aflatoxins and human liver cancer. V. Duration of primary liver cancer and prevalence of hepatomegaly in Thailand

Abstract

Duration and point prevalence of primary liver cancer in rural regions of Thailand were determined to provide a basis for calculating the incidence of this condition. Hospital records of 271 established cases of primary liver cancer in Thailand were reviewed to estimate the usual duration of the disease among Thai patients. Duration is defined here as the interval between first recognition of the disease by a physician and date of death. Mean duration for 184 histologically proven and clinically confirmed cases was 1·3 months; for all cases, including an additional 87 identified only by clinical diagnosis, the interval was 1·1 months. Associated cirrhosis did not affect duration. In two rural regions of Thailand, examination demonstrated a high prevalence of hepatomegaly among 53,076 persons aged 15 yr or more, the age range for primary liver cancer. No case of primary liver cancer was found, a result in accord with the known incidence of the disease. In Singburi, reported to be an area of high liver-cancer incidence and high aflatoxin ingestion, the hepatomegaly rate was 2·7/1000 in persons aged 15 yr or more. The rate in males was twice that in females. In Songkhla, an area where both cancer incidence and aflatoxin ingestion were low and where the overall hepatomegaly rate was 3·4/1000, the male:female ratio was the reverse of that in Singburi. Primary cancer of the liver in Thailand predominates in males in a proportion of 4 to 1. © 1972 Pergamon Press.