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LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 1067-1068
Fermented raw fish, different eating culture, different regions of a country: A case study of culture related carcinogenesis for cholangiocarcinoma endemic area, Thailand


Suvannhabhumi Clinical Training, Research and Development Center, Institute of Natural Medicine Science Development and Establishment Project, Surindra Rajabhat University, Surin Province, Thailand

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Date of Web Publication5-Oct-2017
 

How to cite this article:
Wiwanitkit V. Fermented raw fish, different eating culture, different regions of a country: A case study of culture related carcinogenesis for cholangiocarcinoma endemic area, Thailand. Ann Trop Med Public Health 2017;10:1067-8

How to cite this URL:
Wiwanitkit V. Fermented raw fish, different eating culture, different regions of a country: A case study of culture related carcinogenesis for cholangiocarcinoma endemic area, Thailand. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 21];10:1067-8. Available from: http://www.atmph.org/text.asp?2017/10/4/1067/196638


Dear Editor,

Cholangiocarcinoma is a deadly biliary tract cancer that is related with a tropical parasitic infestation, liver fluke infestation.[1] Its highest prevalence is seen in the Northeastern region of Thailand, a tropical country in Southeast Asia.[1] It is mentioned that intake of fermented raw fish, locally named “Pla-Ra”, is the main risk factor for carcinogenesis of Cholangiocarcinoma and other gastrointestinal cancer in this region.[2] It has been observed that the fermented raw fish is not only consumed by the local people in northeastern region, but also in the other regions of Thailand. However, the significantly higher prevalence of Cholangiorcarcinoma is observed in the northeastern region. The explanation of this finding is very interesting. Since the climate in the different regions of Thailand is more or less same, the geographical parameters might not be the important underlying cause. In fact, a possible important explanation can be based on the difference in the eating culture in the different regions of Thailand. For instance, in the northeastern region, the residents prefer consuming “raw or improperly cooked cyprinid fish”,[3] which is a significant culture different from the local people in other regions. In the northern region of Thailand where the prevalence of liver fluke contamination in cyprinid fresh water fish is similarly high, the local people also consume “Pla-Ra”, but the main difference is the local culture that does not use cyprinid but a bigger fish for performing the “Pla-Ra”. This is a simple but an interesting case study of culture related carcinogenesis for Cholangiocarcinoma endemic area in Thailand. It is very important to understand the local culture for a successful management of endemic problem. Indeed, the recent report by Wiwanitkit also supports that “raw fish intake may not be the sole cause”[4] of Cholangiocarcinoma in Thailand.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Sripa B, Pairojkul C. Cholangiocarcinoma: Lessons from Thailand. Curr Opin Gastroenterol 2008;24:349-56.  Back to cited text no. 1
[PUBMED]    
2.
Suwanrungruang K, Sriamporn S, Wiangnon S, Rangsrikajee D, Sookprasert A, Thipsuntornsak N. et al. Lifestyle-related risk factors for stomach cancer in northeast Thailand. Asian Pac J Cancer Prev 2008;9:71-5.  Back to cited text no. 2
    
3.
Prasongwatana J, Laummaunwai P, Boonmars T, Pinlaor S. Viable metacercariae of Opisthorchisviverrini in northeastern Thai cyprinid fish dishes-as part of a rational program for control of O.viverrini-associated cholangiocarcinoma. Parasitol Res 2013;112:1323-7.  Back to cited text no. 3
[PUBMED]    
4.
Wiwanitkit V. Cholangiocarcinoma and opisthorchiasis in Northeast Thailand: Raw fish intake may not be the sole cause. Rev Soc Bras Med Trop 2015;48:365.  Back to cited text no. 4
[PUBMED]    

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Correspondence Address:
Viroj Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196638

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