Molecular epidemiology of human liver cancer: insights into Gambia (West Africa)

Human liver cancer is the third cause of cancer mortality worldwide, affecting mainly developing countries. Hepatitis B and C viruses and dietary aflatoxin exposure are the main risk factors in the etiology of hepatocellular carcinoma. Through population surveys, field trials and a series of HCC case-control studies, the patterns and natural history of HBV, HCV and aflatoxin exposures have been defined within various populations of the world. These investigations resulted in the development of molecular biomarkers of these etiologic agents and contributed to understanding the complex mechanisms involved in hepatocarcinogenesis. The preventive approaches (HBV vaccination) to reduce the global burden of HCC and molecular epidemiological studies to understand the interaction between the various risk factors carried out in The Gambia (West Africa) are presented and discussed in reference to similar molecular epidemiological studies carried out in South-East Asia and Sub-Sahara Africa.