The rates of hepatocellular carcinoma in some developing countries are many times higher than that in Western nations. A successful hepatocellular carcinoma prevention strategy in these countries would focus on incorporating:

Question

The rates of hepatocellular carcinoma in some developing countries are many times higher than that in Western nations.  A successful hepatocellular carcinoma prevention strategy in these countries would focus on incorporating:

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Worldwide, those countries with high rates of hepatitis B virus (HBV) infection have more than 85% of all hepatocellular carcinoma (HCC) cases. Korea, Taiwan, Mozambique, and China experience the highest annual rates of HCC (36 per 100,000 versus <5 per 100,000 in North America). The individuals who develop HCC in these countries usually have chronic HBV infection acquired through vertical transmission at childbirth, which increases their risk of developing HCC by early to middle adulthood 200-fold. In the United States, HCC normally arises after the age of 60. In these countries with high rates of HBV infection, however, HCC commonly presents in adults 20 to 40 years old. Therefore, universal vaccination of children against HBV would be the one measure most likely to cause a steep decline in the incidence of hepatocellular carcinoma worldwide. (Choice A) Improved water sanitation would be of significant help in reducing the incidence of many foodborne illnesses transmitted through the fecal-oral route (such as hepatitis A). (Choice B) Vitamin supplementation would be of significant help in reducing the incidence of conditions associated with poor nutrition (eg, pellagra). (Choice D) Adequate antibiotic usage would be of significant help in reducing the length and severity of bacterial infections. (Choices E and F) Routine physician check-ups and wider access to hospital care would be of significant help in educating the patient population, identifying disease processes in early stages, and reducing suffering. Educational Objective: Universal vaccination of children against HBV would likely cause a steep decline in the worldwide incidence of hepatocellular carcinoma.

The Rates of Hepatocellular Carcinoma in Some Developing Countries Are