RESUMO
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths in Africa. In Africa, the major causes of HCC include chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV). Knowledge of the changes in the incidence of viral hepatitis-associated HCC over time and the factors responsible for such changes is key in informing policies for the prevention of viral hepatitis-associated HCC in Africa. AIM: The study aimed to systematically summarize the changes in the prevalence of viral hepatitis among HCC patients and the overall effect of the prevalence of viral hepatitis on the incidence of HCC over the past four decades in Africa (1980-2019). METHODS: A literature search was conducted in MEDLINE (PubMed), Google Scholar, Science Direct, Scopus, Web of Science, and African wide web for articles published on viral hepatitis-associated HCC in Africa from 1980 to 2019. The abstracts of the articles were screened for eligibility and those meeting the inclusion criteria were retrieved and reviewed. RESULTS: A total of 272 studies were included in the analysis. Viral hepatitis-related HCC incidence changed by 1.17% (95% confidence interval (CI): 0.63-1.71, p < 0.001), 0.82% (95% CI: 0.45-1.18, p < 0.001), and 3.34% (95% CI: 2.44-4.25, p < 0.001) for every 1% change in the prevalence of HBV, HCV, and hepatitis D virus (HDV) respectively, per decade. The incidence of HBV-related HCC decreased by - 0.50% (95% CI: - 0.74 - - 0.25, p < 0.001) over the last 40 years, while HCV-related HCC increased. CONCLUSION: Overall, the incidence of viral hepatitis-associated HCC has not declined, mainly due to no decline in the prevalence of HCV, HDV, and the high number of chronic hepatitis B carriers on the African continent. There is an urgent need for the allocation of resources for the implementation of treatment and preventive programs for HBV, HCV, HDV, and HCC in Africa. This systematic review is registered with PROSPERO®, number CRD42020169723.
Assuntos
Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/virologia , Hepatite B/complicações , Hepatite C/complicações , Hepatite D/complicações , Hepatite Viral Humana/complicações , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/virologia , África , Carcinoma Hepatocelular/fisiopatologia , Hepatite B/patologia , Hepatite C/patologia , Hepatite D/patologia , Hepatite Viral Humana/patologia , Humanos , Neoplasias Hepáticas/fisiopatologiaRESUMO
BACKGROUND: Early detection of colon cancer leads to better survival outcomes. This can be achieved through colorectal cancer (CRC) screening. People with a family history of cancer (FHC) have increased risk of developing CRC. Increasing screening in this group will reduce CRC mortality. This study evaluated CRC screening in people with FHC. METHODS: The study used data from the Health Information National Trends Survey (HINTS) 5, cycle 3. This is an annual cross-sectional survey with a nationally representative sample of American adults. The objective was to study the association between FHC and performing CRC screening. Propensity score matching was used to create a matched population with variables that constituted beliefs in cancer from the survey. Replication procedure, which is based on repeated sampling and allows for accurate computation of standard errors, was used for calculating statistical tests. Multivariable models were fitted in the matched population to assess the association between FHC and performing CRC screening. RESULTS: People with FHC were 14% (OR = 1.14; 95% CI: 0.81-1.60) more likely to perform CRC screening than those without FHC, even though not statistically significant. Age in years (OR = 1.14; 95% CI: 1.12-5.27) had increased likelihood of performing CRC screening, while other races such as American Indians/Alaskan Natives (except African Americans) compared to Caucasians (OR = 0.49; 95% CI: 0.29-0.84) had significantly decreased likelihood of performing CRC screening. CONCLUSION: FHC was not significantly associated with having a colorectal cancer screening test. Public health advocacy should be directed towards increasing awareness of CRC screening among people with FHC.
Assuntos
Neoplasias Colorretais , Detecção Precoce de Câncer , Adulto , Humanos , Estados Unidos/epidemiologia , Pontuação de Propensão , Estudos Transversais , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/genética , Inquéritos e Questionários , Programas de RastreamentoRESUMO
Aims: This study aims to examine the racial and ethnic disparity in cancer prevalence and determine if comorbidities can explain this disparity. Study design: This was a cross-sectional study. Methods: The study examined cancer prevalence among adults who self-identified as White, Black, and Other races in the US population according to data from the 2017 National Health Interview Survey. Results: Cancer was 58.5% [OR = 0.415; 95% CI: 0.346-0.498] and 57.5% [OR = 0.425; 95%CI: 0.346-0.522] more likely to be found in the White compared to the Black adults and White compared to Other race adults, respectively. After adjusting for the comorbidities, the odds of cancer in White adults increased marginally compared to Black adults [OR = 0.407; 95%CI: 0.338-0.490] and decreased marginally compared to Other race adults [OR = 0.462; 95%CI: 0.374-0.569] even though the odds remained significant. Ever smoking, age of 50 years or more, Former and current alcohol consumption, overweight and obesity, being female and physical inactivity were found to be significantly associated with higher odds of cancer. Conclusions: This study did identify a racial and ethnic disparity in cancer prevalence between White and Black adults and White and Other adult races. However, this racial and ethnic disparity could not be explained by comorbidities.