The Cancer in Sub-Saharan Africa volume brings together population-based cancer incidence data from 25 cancer registries in 20 sub-Saharan African countries that are part of the African Cancer Registry Network. The compiled data in this volume, presented and commented upon by covered population and by anatomical site, are of tremendous value to the assessment of the pattern and evolution of cancer in Africa, as a means of elucidating, confirming, and evaluating causes of the disease.

The book comprehensively covers all aspects of hepatocellular carcinoma (cancer) as it occurs in sub-Saharan black Africans and how the cancer differs from that in other parts of the world, in most of which it occurs infrequently. The first chapter is introduced with a discussion of the difficulty in recording all cases of this cancer in sub Saharan Africa and then covers its epidemiology, emphasising the very high incidence of liver cancer in sub Saharan black Africans. The relatively young age at which the tumor occurs in comparison with the older age of the patients in resource-rich regions is stressed. The sex distribution of the cancer is also discussed. The second chapter describes the ways in which hepatocellular cancer presents in black Africans, its symptoms and signs, and how its presentation differs from that in other parts of the world. The third chapter summarises the grave outlook for patients with the tumor, the very short survival times of the patients, and the reasons for their deaths. The fourth chapter discusses the diagnosis of the cancer and why this is far more difficult than it is in resource-rich countries. The fifth chapter deals with the pathology of the tumorits similarities and differences from that in other parts of the world. The sixth chapter is the longest in the book, and it deals comprehensively with the causes of liver cancer in sub-Saharan Africa. The major cause is chronic infection with the hepatitis B virus, an infection acquired in early childhood, and the possible mechanisms by which this may cause the cancer. Other less common but still important causes in the subcontinentsuch as exposure to the fungal carcinogen, aflatoxin, chronic hepatitis C virus infection, dietary iron overload among Africans, and membranous obstruction of the inferior vena cavaare also discussed. The seventh chapter discusses the difficulty in treating hepatocellular cancer and the poor results obtained in sub-Saharan Africa in comparison with the results of treatment in industrialized countries. The penultimate chapter presents possible ways to prevent the cancer or, at least, to detect it at a far earlier time than is currently the case and when it may be more amenable to treatment. The current status of vaccination in preventing hepatitis B virus infection, and hence liver cancer, is discussed in detail. The final chapter asks the question, How can we improve the diagnosis and treatment of this dreadful malignant disease?

Digestive Diseases in Sub-Saharan Africa: Changes and Challenges provides an in-depth examination into the rise of western digestive diseases in Sub-Saharan Africa (SSA). For those interested in the causes of the major diseases of the 'West', the patterns in Africa have always reflected on the emergence of western diseases and elucidated the pattern of these conditions and their clinical course. Coverage includes the present epidemiology of GI diseases in SSA, the trends that are occurring, and the context of other emerging diseases. Appropriate for researchers, gastroenterologists and internists, this book brings together the latest research in a single, complete volume. - Provides evidence of the changes occurring in digestive disease in Sub-Saharan Africa due to Westernization - Covers urbanization, upward mobility, demographics, environmental changes, and the availability of natural resources that have a decisive influence on digestive diseases - Offers models for the amelioration of digestive diseases due to Westernization

This book discusses the current state of cancer pathway as it is relevant to sub-Saharan Africa and highlights differences in epidemiology and the underlying problems with management. It outlines the current practice and opinions in all forms of cancer, also highlighting future prospects. Starting by providing background information on the epidemiology and genomic variations, the book then goes on to look at Infection-related cancers and continues to prostate GI, breast cancer and ovarian and cervical cancer. The last part of the book focuses on delivery of affordable and accessible care. Palliative services and primary and transnational research, as well as clinical trials are also discussed. Written by a team of authors based in the UK, Nigeria, South Africa and the US. this book offers an overview of the current state and challenges of cancer care in sub-Saharan Africa, and it would be valuable to policy makers, researchers, funding organisations, and can be an adjunct to standard text books for students, residents and established doctors.

Hepatocellular carcinoma is one of the most common fatal malignan cies of mankind. Up to a few decades ago it was looked upon as a cancer which aroused mainly academic concern but relatively little clinical interest, because its therapy and prognosis had a most un favorable outlook. Indeed, it was mostly recognized only at autopsy. Recently this pessimism has radically changed and is disappearing to a rapidly accelerating degree. Many of the scientific contributions at this change in outlook are the result of research in the Far East, first, Japan and then gradually extending to its neighbors. The introduction of experimental hepatocarcinogens by Yoshida more than 50 years ago may have been one of the first important steps. Hepatocellular car cinoma shows a characteristic geographical distribution. With the highest incidence in China, Taiwan, Southeast Asia and sub-Saharan Africa, followed by southern and eastern Europe, while generally the incidence is rather low in western and northern Europe and North and South America.

Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.

The second edition, which appears seven years after the first, is a more comprehensive text and addresses the many recent advances in basic and clinical science applicable to autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune aspects of viral-, drug- and alcohol-induced liver disease and hepatocellular cancer. Pathogenesis, diagnosis and treatment are discussed in depth in light of current understanding of the molecular mechanisms of autoimmunity as it applies to liver disease.