As at November, 2019 the NCRI cancer conference reported a triple- fold increase in deaths arising from liver cancer in England than ever before.
The survey covered a 20-year period between 1997 and 2016 confirmed that this was common among the most deprived of the society. As a matter of fact, there has been a 80% rise in liver cancer deaths in the UK In April, 2019. The American Cancer Society noted that liver cancer is the fastest growing cause of cancer deaths in the USA and the targets are the adult men with less education. The data for Africa are not yet ready!!. Although obesity and excessive alcohol intake were the candidate risk factors, little attention has been placed on the consumption of unwholesome food items particularly laden with aflatoxins. Most of the vulnerable were the uneducated and economically challenged, who are forced by circumstance, not choice, to take any food item, whatever may be the hygienic state.
The Liver Foundation, an American NGO has set aside October as Liver cancer awareness month in recognition of the scare and threat of the deadly morbidity. It is recalled that Oct 17 is marked every year to bring attention to the need to eradicate all forms of extreme poverty, including malnutrition. The Africa Union recognizes the consumption of aflatoxin- dense food as a form of malnutrition, which in itself, is an emblem of poverty. Since it is established that, across the world, liver cancer deaths are traceable to, hepatitis B and C as well as alcohol and aflatoxin consumption, poverty and lack of education are being scandalously left out and have to be addressed. Most post -harvest food items, like maize, groundnut, guinea corn, millet, soybean and rice in Africa are targets of moulds which produce aflatoxins that cannot be detected by ordinary eyes and devoid of odour or taste. These toxins are a group of compounds, secreted on food items in store, transit or on farms. One of the members is the aflatoxin B1, a compound recognised by the International Agency for Research on Cancer, IARC, an arm of the WHO, to have the ability to incite cancer, thus locating it as Group 1 carcinogen. Set up in 1965, the IARC coordinates and conducts both epidemiological and laboratory research into the causes of human cancer . Aflatoxin is the only product of living source that has such attribute.
Detection of aflatoxin in food is expensive, making it easily, innocently accessed and the spread uncontrollable. In the UK alone, about 6000 people are diagnosed with liver cancer each year. In the USA, about 42,000 people are expected to be told they have liver cancer this year 2019. What is the profile for Africa? In an economically challenged Africa, where it is difficult to convince people to throw away unwholesome food items, particularly where other options are either expensive or not available, it is certain that aflatoxin consumption will contribute to the incidence of liver cancer. Intervention measures by Africa include PACA, the Partnership for Aflatoxin Control in Africa, with external funding. The PACA has been operating in selected countries and it is hoped that the extension department of the scheme will be rejigged to achieve a measure of hope for the continent. When farmers and exporters are not aware or equipped with the basics of food safety, only contaminated crops will result, leading to health compromise and export rejects or even trade bans. In Africa, data on risk assessment are sparse and uncoordinated, with little interdisciplinary collaboration, Yet, and most unfortunately, most of the materials rejected at the point of entry as exports to Europe, are consumed locally here in Africa.
Food safety activities and departments should be decentralized for small holder farmers and operators to have a better feel of the impact. Commodity associations should be streamlined to emphasize compliance with standards before release to the market. Also, awareness campaigns should be intensified consciously by research institutes, regulatory agencies, the Press and NGOs. Since the UN promotes fair global trade, the World Trade Organization also has a role to play. Research should now, focus on the manufacture of farmer-friendly hand-held tools or sensors that can easily detect, whether qualitatively or semi quantitatively, contaminants in food, on site. At present, detection techniques are fairly time consuming, expensive and highly technical.
Prevention remains the most effective intervention approach and biological input is an attraction.