Geoepidemiology of hepatocellular carcinoma in the island of Crete, Greece. A possible role of pesticides

Sifaki-Pistolla, Dimitra; Karageorgos, Spyridon A.; Koulentaki, Mairi; Samonakis, Dimitrios; Stratakou, Soultana; Digenakis, Emmanuel

doi:10.1111/liv.13034

Cited by 8 publications

(7 citation statements)

References 37 publications

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“…Kamposioras et al carried out another important cancer screening study in Greece in 2008 with the purpose of estimating the incidence of cancer in the Greek population and the difficulties for early diagnosis [ 10 ]. Crete constitutes a homogeneous population geographical area with no significant differences in population composition from the rest of the country, so it was not expected that there would be a difference compared to the rest of Greece in terms of incidence of viral hepatitis as well as of malignant liver tumors, especially in particular areas of the island [ 8 ]. These results strengthen the hypothesis that possible factors related to the habits of the residents and the environment may be the cause of the increased incidence of the disease.…”

Section: Discussionmentioning

confidence: 99%

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Reporting Liver Cancer Trends in the Island of Crete, Greece: Results from a Geo-Epidemiological Study

Kalpadakis

Sifaki-Pistolla

Symvoulakis

et al. 2022

IJERPH

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Liver cancer is one of the most frequent cancers in Europe and Greece. An increase in specific risk factors, such as metabolic syndrome and obesity, has been observed in Greece. Therefore, exploring temporal trends of liver cancer incidence and mortality is crucial. This study aims to assess the “burden” of malignant liver tumors (MLT) in Crete, Greece, in terms of incidence and mortality rates, and identify the high-risk areas on the island (i.e., municipalities), to suggest public health measures. Data were obtained from the Cancer Registry Center (CRC) and included all cases of MLT for the period 1992–2013 in Crete. Age-standardized incidence rates (ASIR), age-specific incidence rates (ASpIR), age-standardized mortality rates (ASMR), and age-specific mortality rates (ASpMR) were estimated. For the study period (1992–2013), incidence and mortality showed an increasing trend. Mean ASIR was found 15.3/100,000/year and mean ASMR 8.6/100,000/year. Age groups 65–69 and 75–79 years among men presented the highest rates of (ASIR = 39/100,000/year) and among women age groups of 75–79 and 80–84 years a mean ASIR (22/100,000/year). The five-year survival rate of MLT was 50% and the ten-year survival rate was 47% for both genders. Risk factors that were identified included personal history of cancer, family history of MLT or other cancer, degree of relationship, smoking, and obesity. Some municipalities of Crete were found to be high-risk areas for MLT, while differences were detected in incidence and mortality rates, and annual rate change among them. Estimated variation indicates further increase probably due to the lifestyle of the residents, economic crisis, and inadequate preventive measures.

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Section: Discussionmentioning

confidence: 99%

“…Prediction and spatiotemporal analysis through mathematical polynomials and interpolation models were also applied. Specifically, the following tests were performed: spatial mean/median, spatial eclipse, spatiotemporal projection models, hot spots analysis, and kriging interpolation Bayesian models based on literature [ 8 ].…”

Section: Methodsmentioning

confidence: 99%

Reporting Liver Cancer Trends in the Island of Crete, Greece: Results from a Geo-Epidemiological Study

Kalpadakis

Sifaki-Pistolla

Symvoulakis

et al. 2022

IJERPH

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“…A homogenous national policy may not be effective due to inequalities in HCV prevalence. Understanding the impact of region and district on HCV infection can ensure that intervention is effective in areas with higher infection rates [ 40 , 41 ]. HCV infections are particularly more prevalent in the southern and eastern districts, but this could have been due to the increasing number of African immigrants in these regions.…”

Section: Discussionmentioning

confidence: 99%

The geographic variation and spatiotemporal distribution of hepatitis C virus infection in Libya: 2007–2016

et al. 2018

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BackgroundHepatitis C Virus infection has been considered an important hidden pandemic in developing countries, particularly in Africa. It varies greatly from one region to another and even within districts of the same region. Macroscopic geospatial analysis has become an important scientific tool for identifying the density and clustering of HCV infection and provides epidemiological information for planning interventions and control strategies. The application of these parameters provides a better knowledge of the hepatitis C virus infection prevalence at the national level and can help to implement pertinent strategies to address the HCV-related burdens. This study aims to determine the geographical variability of HCV infection in Libya and to identify the hot spots within regions and districts of the country, and to analyze the population-based demographic determinants involved and outline the intervention programs needed.MethodsDisease mapping and spatial analysis were conducted using geographic information data available on all documented cases of HCV infections in Libya between 2007 and 2016. Spatial autocorrelation was tested using Moran’s Index, which determines and measures the degree of clustering and dispersion of HCV infection in a country.ResultsA total 114,928 HCV infection cases during a ten-year period with accurate geographic information were studied. Ages ranged between 16 and 50 years and the male to female ratio was 2:1. HCV infection was unevenly distributed in Libya, and its incidence increased steadily over the study period. Several hot spots and cold spots were found mainly in the southern and eastern regions of the country.ConclusionHCV infection in Libya was geographically variable, with several hot spots particularly in eastern and southern Libya associated with different demographic determinants. Future intervention planning should consider the geospatial variability and risk factors involved.

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“…The results of their study revealed a higher than expected spatial distribution of HCC in an area with a widespread use of pesticides (104). As regards the mechanisms through which pesticides can induce HCC, recently, it has been demonstrated that methyl parathion and chlorpyrifos negatively modulate the expression of the paraoxonase 1 (PON1) gene in human HCC (HepG2) cells through a mechanism that involves the induction of inflammatory cytokines, such as tumor necrosis factor (TNF)-α, IL-6, and IL-1β.…”

Section: Pesticidesmentioning

confidence: 91%

Occupational exposure to carcinogens: Benzene, pesticides and fibers

Falzone

Marconi

Loreto

et al. 2016

Molecular Medicine Reports

100

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It is well known that the occupational exposure to contaminants and carcinogens leads to the development of cancer in exposed workers. In the 18th century, Percivall Pott was the first to hypothesize that chronic exposure to dust in the London chimney sweeps was associated with an increased risk of developing cancer. Subsequently a growing body of evidence indicated that other physical factors were also responsible for oncogenic mutations. Over the past decades, many carcinogens have been found in the occupational environment and their presence is often associated with an increased incidence of cancer. Occupational exposure involves several factors and the association between carcinogens, occupational exposure and cancer is still unclear. Only a fraction of factors is recognized as occupational carcinogens and for each factor, there is an increased risk of cancer development associated with a specific work activity. According to the International Agency for Research on Cancer (IARC), the majority of carcinogens are classified as ‘probable’ and ‘possible’ human carcinogens, while, direct evidence of carcinogenicity is provided in epidemiological and experimental studies. In the present review, exposures to benzene, pesticides and mineral fibers are discussed as the most important cancer risk factors during work activities.

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Geoepidemiology of hepatocellular carcinoma in the island of Crete, Greece. A possible role of pesticides

Abstract: Hepatocellular carcinoma is associated with the dispersion of HCV and HBVs. In an area with widespread use of pesticides, a higher than expected spatial distribution of HCC was detected.

Cited by 8 publications

References 37 publications

Reporting Liver Cancer Trends in the Island of Crete, Greece: Results from a Geo-Epidemiological Study

Reporting Liver Cancer Trends in the Island of Crete, Greece: Results from a Geo-Epidemiological Study

The geographic variation and spatiotemporal distribution of hepatitis C virus infection in Libya: 2007–2016

Occupational exposure to carcinogens: Benzene, pesticides and fibers

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