Observations on cirrhosis and liver cancer at Dakar, French West Africa.

The work here reported was a part of a larger study on the etiology of human liver cancer carried out by one of us (P. E. S.) in 1957 in trans-Saharan Africa. By a combination of statistical and pathological methods, with the use of geographical and ethnic comparisons, it was hoped that environmental and truly racial factors might be dissociated and that, by studying the cancers and types of precursor and associated lesions such as cirrhosis, light might be shed on the factors alleged to be of etiological importance. By comparing cancer in areas with and without these factors, some of them might be eliminated as not essential or incriminated as etiologically important. A special analysis was made of the cirrhosis:cancer relationship based on this comparatively vast amount of material. Dakar was selected as one place for study because of the large amount of carefully studied material available owing to previous great interest in these diseases. In a series of publications, the clinical and pathological features had been described (1, 3, 13, 14). In the present study some of this material was analyzed in new ways and by methods that exactly duplicated those used in other parts of Africa and in the United States. The purpose of this paper is to characterize cirrhosis and liver cancer at Dakar, and to make comparisons with observations in the United States (5, 18). This report is based on a study of 238 cases of