Cancer of the pancreas has a 7O% higher incidence among African-Americans than among whites (NCI,1990). The reason for this higher risk is unknown. It has been assumed that cancer of the pancreas is not a frequently encountered malignancy in Africa, and, therefore, its epidemiology among African black populations has not been comprehensively studied. Analytic epidemiologic studies, in particular, are almost non-existent. We have collected preliminary data which suggest that this tumor is much more common in Senegal, West Africa, than previously suspected. By studying the epidemiology of cancer of the pancreas in Africa, we believe that we will develop clues to the etiology of pancreatic cancer in the U.S. Infectious etiologies of pancreatic cancer have not been adequately investigated. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are much more prevalent among blacks than among whites in the United States, and both infections are also found in moderate to high levels in Senegal. Both viruses are associated with primary hepatocellular carcinoma (PHC). HBV is known to infect the pancreas, and the range of extrahepatic sites for HCV infection is unknown. We propose a hospital-based case-control study of pancreatic cancer in Senegal, focused on infectious etiologies.
The specific aims are the following: 1. To test the hypothesis that cancer of the pancreas is associated with chronic infection with one or more of the following hepatitis viruses: Hepatitis B virus, hepatitis C virus, hepatitis D (delta) virus. 2. To evaluate the hypothesis that hepatitis virus infections in conjunction with other environmental and life-style risk factors are associated with a higher risk of pancreatic cancer than any of these factors alone. Environmental and life-style factors to be evaluated include staple diet, history of malnutrition, tobacco smoking, and alcohol use. 3. To collect data and biological samples from pancreatic cancer cases and controls in Senegal to permit future investigations of other hypotheses concerning roles for Helicobacter pylori infection and aflatoxin exposure in the etiopathogenesis of cancer of the pancreas.
