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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 4  |  Page : 1072
Living in the same environment and having the same food dishes: But why there is a significant difference of prevalence of cholangiocarcinoma between male and female in Thailand


1 KMT Primary Care Center, Bangkok, Thailand
2 Hainan Medical University, China

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Date of Web Publication5-Oct-2017
 

How to cite this article:
Yasri S, Wiwanitkit V. Living in the same environment and having the same food dishes: But why there is a significant difference of prevalence of cholangiocarcinoma between male and female in Thailand. Ann Trop Med Public Health 2017;10:1072

How to cite this URL:
Yasri S, Wiwanitkit V. Living in the same environment and having the same food dishes: But why there is a significant difference of prevalence of cholangiocarcinoma between male and female in Thailand. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 22];10:1072. Available from: http://www.atmph.org/text.asp?2017/10/4/1072/196673


Dear Editor,

Cancer becomes the big public health threat. In each area, endemic cancer might relate to the underlying gene-environmental background. In Thailand, cholangiocarcinoma is the cancer with very high prevalence, higher than anywhere else in our world.[1] The interesting issue is also the significant difference of prevalence among male and female local population.[2]

Indeed, cholangiocarcinoma is proved to be relating to intake of raw fish carrying liver fluke metacercariae. However, there is a fact to be noted that both local males and females share and live in the same environment and also have the same food dishes. Focusing on the underlying genetic polymorphism, it is noted that polymorphisms in XRCC1 and OGG1 genes are underlying genetic risks for several cancers in Thailand including to cholangiocarcinoma but it should be noted that there is no difference in frequency of the mentioned polymorphisms in Thai males and females.[3],[4] The question on why the prevalence of cholangiocarcinoma between male and female in Thailand is extremely different is interesting. First, the role of sex hormone is discussed. However, there is still inconclusive data on this issue. Some reports mentioned for the role of male sex hormone as trigger factor for cholangiocarcinogenesis whereas the other mentioned for the role of female sex hormone.[5],[6]

The exact explanation still needs further epidemiological study and translation research to support. Nevertheless, the authors hereby would like to discuss on the local culture. In the endemic area, local males, husband, usually drink alcohol and not let their wives to drink together. They share same food dishes of raw fish but they did no share the same alcoholic beverage. As a results, both local Thai males and females have high prevalence of liver fluke infestation.[1] Indeed, alchoholic drinking is detected to be an important contributing risk for cholangiocarcinogenesis.[7] Indeed, in a recent report from Thailand, it is concluded that “alcohol consumption can exacerbate cholangiofibrosis, cholangitis, and lithiasis, which are risk factors for cholangiocarcinoma.''[8]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Mathema VB, Na-Bangchang K. Current insights on cholangiocarcinoma research: a brief review. Asian Pac J Cancer Prev 2015;16:1307-13.  Back to cited text no. 1
[PUBMED]    
2.
Wiwanitkit V. Clinical findings among 62 Thais with cholangiocarcinoma. Trop Med Int Health 2003;8:228-30.  Back to cited text no. 2
[PUBMED]    
3.
Songserm N, Promthet S, Pientong C, Ekalaksananan T, Chopjitt P, Wiangnon S. Gene-environment interaction involved in cholangiocarcinoma in the Thai population: polymorphisms of DNA repair genes, smoking and use of alcohol. BMJ Open 2014;4:e005447.  Back to cited text no. 3
[PUBMED]    
4.
Sangrajrang S, Schmezer P, Burkholder I, Waas P, Boffetta P, Brennan P. et al. Polymorphisms in three base excision repair genes and breast cancer risk in Thai women. Breast Cancer Res Treat 2008;111:279-88.  Back to cited text no. 4
    
5.
Liossi AK, Aroni KG, Kyrkou KA, Kittas C, Markaki SP. Immunohistochemical study of sex steroid hormones in primary liver cancer. Cancer Detect Prev 1988;13:195-201.  Back to cited text no. 5
[PUBMED]    
6.
Turani H, Levi J, Zevin D, Kessler E. Hepatic lesions in patients on anabolic androgenic therapy. Isr J Med Sci 1983;19:332-7.  Back to cited text no. 6
[PUBMED]    
7.
Parkin DM, Srivatanakul P, Khlat M, Chenvidhya D, Chotiwan P, Insiripong S, et al. Liver cancer in Thailand. I. A case-control study of cholangiocarcinoma. Int J Cancer 1991;48:323-8.  Back to cited text no. 7
    
8.
Sriraj P, Aukkanimart R, Boonmars T, Juasook A, Sudsarn P, Wonkchalee N. et al. Does a combination of opisthorchiasis and ethyl alcohol consumption enhance early cholangiofibrosis, the risk of cholangiocarcinoma?. Parasitol Res 2013;112:2971-81.  Back to cited text no. 8
    

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Correspondence Address:
Sora Yasri
KMT Primary Care Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.196673

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