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      Liver cancer in Hidalgo State, Mexico: analysis of the status, risk factors and regional public health policy requirements: a cross-sectional correlational study

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          ABSTRACT

          BACKGROUND:

          In Latin America, liver cancer is one of the top causes of cancer mortality. It is the fifth most common cause of death among malignant tumors in Mexico and is the leading cause in Hidalgo State (43.8% of the population living in poverty).

          OBJECTIVE:

          To conduct a correlational analysis on the main risk factors for liver cancer in Hidalgo State, Mexico, including municipal disaggregation and comparison with the national level.

          DESIGN AND SETTING:

          Cross-sectional, correlational, descriptive and comparative epidemiological study using Mexican governmental databases covering 1990-2019.

          METHODS:

          A comprehensive review of the databases of the General Directorate of Health Information (DGIS) was performed to analyze official death figures, hospital discharges and national and municipal population projections, using specific search criteria defined in the Global Burden of Disease classification, based on the risk factors for liver cancer.

          RESULTS:

          Liver cancer rates showed an evident rise in Hidalgo (183%), moving from 21 st place in Mexico in 1990 to 9 th place in 2019. This increase was correlated with alcoholism. An increasing trend for liver cancer deaths, of 133.89%, is projected for 2030. Females and the population over 60 years of age are more affected. There are some critical regions with liver cancer death rates twice the national rate or more.

          CONCLUSION:

          Targeted effective public health strategies should be structured by identifying, characterizing and regionalizing critical marginalized municipalities that are vulnerable to alcoholism and other risk factors for liver cancer. This approach may be helpful for other states in Mexico or similar countries.

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          Most cited references36

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Epidemiology of hepatocellular carcinoma: consider the population.

            Hepatocellular carcinoma (HCC) is increasing in incidence and has a very high fatality rate. Cirrhosis due to chronic hepatitis B or hepatitis C is the leading risk factor for HCC. Global epidemiology of HCC is determined by the prevalence of dominant viral hepatitis and the age it is acquired in the underlying population. Upcoming risk factors include obesity, diabetes, and related nonalcoholic fatty liver disease. This review discusses the latest trends of HCC globally and in the United States. It also provides an evidence-based commentary on the risk factors and lists some of the preventive measures to reduce the incidence of HCC.
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              The changing pattern of epidemiology in hepatocellular carcinoma.

              Primary liver cancer (PLC) represents approximately 4% of all new cancer cases diagnosed worldwide. The purpose of this review is to describe some of the latest international patterns in PLC incidence and mortality, as well as to give an overview of the main etiological factors. We used two databases, GLOBOCAN 2002 and the World Health Organization (WHO) mortality database to analyze the incidence and mortality rates for PLC in several regions around the world. The highest age adjusted incidence rates (>20 per 100,000) were reported from countries in Southeast Asia and sub-Saharan Africa that are endemic for HBV infection. Countries in Southern Europe have medium-high incidence rates, while low-incidence areas (<5 per 100,000) include South and Central America, and the rest of Europe. Cirrhosis is present in about 80-90% of HCC patients and is thereby the largest single risk factor. Main risk factors include HBV, HCV, aflatoxin and possibly obesity and diabetes. Together HBV and HCV account for 80-90% of all HCC worldwide. HBV continues to be the major HCC risk factor worldwide, although its importance will most likely decrease during the coming decades due to the widespread use of the HBV vaccine in the newborns. HCV has been the dominant viral cause in HCC in North America, some Western countries and Japan. Obesity and diabetes are increasing at a fast pace throughout the world, and if they are proven to be HCC risk factors, they would account for more HCC cases in the future. Copyright 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd.. All rights reserved.

                Author and article information

                Journal
                Sao Paulo Med J
                Sao Paulo Med J
                spmj
                São Paulo Medical Journal
                Associação Paulista de Medicina - APM
                1516-3180
                1806-9460
                27 June 2022
                Jul-Aug 2022
                : 140
                : 4
                : 574-582
                Affiliations
                [I ]MD, MPH. Family Medicine Specialty Student, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo (UAEH), Pachuca, Hidalgo, Mexico.
                [II ]BSc, MSc, PhD. Full Professor, Department of Mathematics and Physics, School of Basic Sciences and Engineering, Universidad Autónoma del Estado de Hidalgo (UAEH), Pachuca, Hidalgo, Mexico.
                [III ]BSc, MSc. Doctoral Student, Department of Mathematics and Physics, School of Basic Sciences and Engineering, Universidad Autónoma del Estado de Hidalgo (UAEH), Pachuca, Hidalgo, Mexico.
                [IV ]MD, PhD. Full Professor, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo (UAEH), Pachuca, Hidalgo, Mexico.
                [V ]MD, PhD. Full Professor, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo (UAEH), Pachuca, Hidalgo, Mexico.
                [VI ]MD, MSc, PhD. Full Professor, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo (UAEH), Pachuca, Hidalgo, Mexico.
                [VII ]BSc, MSc, PhD. Full Professor, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo (UAEH), Pachuca, Hidalgo, Mexico.
                Author notes
                Address for correspondence: Eduardo Fernández-Martínez. Laboratory of Medicinal Chemistry and Pharmacology, Biology Research Center in Reproduction, Department of Medicine, School of Health Sciences, Universidad Autónoma del Estado de Hidalgo (UAEH). Calle Dr. Eliseo Ramírez Ulloa, 400. Colonia Doctores, Pachuca Hidalgo, México. 42090. Tel. (+52) 771 717 2000 ext. 2368. E-mail: efernan@ 123456uaeh.edu.mx

                Authors’ contributions: Barrera-Cortés RI: conceptualization (lead), data curation (lead), formal analysis (lead), investigation (equal), methodology (lead), resources (equal) and software (lead); Rodríguez-Torres EE: conceptualization (lead), formal analysis (lead), investigation (supporting), methodology (lead), software (lead) and supervision (lead); Vázquez-Mendoza E: data curation (supporting), formal analysis (supporting), methodology (supporting), software (lead) and validation (lead); Ruvalcaba-Ledezma JC: formal analysis (lead) investigation (supporting), methodology (lead), supervision (supporting) and visualization (lead); Soria-Jasso LE: data curation (equal), investigation (equal), methodology (equal), resources (supporting) and software (supporting); Ortiz MI: formal analysis (supporting), investigation (equal), methodology (equal), software (equal) and writing-review and editing (equal); Fernández-Martínez E: conceptualization (lead), formal analysis (lead), investigation (equal), project administration (lead), resources (lead), supervision (lead), visualization (lead), writing-original draft (lead) and writing-review and editing (lead)

                Conflicts of interest: The authors declare that there were no conflicts of interest

                Author information
                http://orcid.org/0000-0002-9849-3178
                http://orcid.org/0000-0002-7738-1863
                http://orcid.org/0000-0002-4244-6161
                http://orcid.org/0000-0002-5593-3946
                http://orcid.org/0000-0002-6581-7295
                http://orcid.org/0000-0003-1047-6304
                http://orcid.org/0000-0003-3280-1323
                Article
                10.1590/1516-3180.2021.0601.R1.121121
                9491469
                35766636
                6a820f7b-ca56-40bf-9b8c-3dd3679e02e5

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 08 July 2021
                : 04 October 2021
                : 12 November 2021
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 29
                Categories
                Original Article

                alcoholism,health policy,liver neoplasms,regional medical programs,risk factors,public health,cirrhosis,hepatocellular carcinoma,marginalization,non-alcoholic steatohepatitis,regional strategies

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