Cannabis, tobacco and domestic fumes intake are associated with nasopharyngeal carcinoma in North Africa.

BACKGROUND: The lifestyle risk factors for nasopharyngeal carcinoma (NPC) in North Africa are not known. METHODS: From 2002 to 2005, we interviewed 636 patients and 615 controls from Algeria, Morocco and Tunisia, frequency-matched by centre, age, sex, and childhood household type (urban/rural). Conditional logistic regression was used to evaluate the association of lifestyles with NPC risk, controlling for socioeconomic status and dietary risk factors. RESULTS: Cigarette smoking and snuff (tobacco powder with additives) intake were significantly associated with differentiated NPC but not with undifferentiated carcinoma (UCNT), which is the major histological type of NPC in these populations. As demonstrated by a stratified permutation test and by conditional logistic regression, marijuana smoking significantly elevated NPC risk independently of cigarette smoking, suggesting dissimilar carcinogenic mechanisms between cannabis and tobacco. Domestic cooking fumes intake by using kanoun (compact charcoal oven) during childhood increased NPC risk, whereas exposure during adulthood had less effect. Neither alcohol nor shisha (water pipe) was associated with risk. CONCLUSION: Tobacco, cannabis and domestic cooking fumes intake are risk factors for NPC in western North Africa.

[Prevalence of type 2 diabetes mellitus and glucose intolerance in the Setif area (Algeria)]. / Prévalence du diabète de type 2 et de l'intolérance au glucose dans la région de Sétif (Algérie).

OBJECTIVE: Diabetes mellitus stands as a major public health issue in Algeria and has an important socioeconomical impact. Our study involved a representative sample of 1457 subjects and aimed at assessing the prevalence of type 2 diabetes and glucose intolerance in the population of Setif Wilaya, aged between 30 and 64 years old. MATERIAL AND METHODS: Diagnosis was based on oral glucose tolerance test, according to World Health Organisation criteria. RESULTS: Diabetes prevalence was 8.2% (CI: 95%: 6.8% to 9.6%). It increased with age, while 50% of cases were undiagnosed, without any difference according to sex nor urban (7.3%)/rural (9.7%) distribution. Glucose intolerance prevalence was 7.1 (CI 95%: 5,8% to 8,4%). Age-standardized prevalence, according to world population data provided by WHO, was 9.08% for diabetes and 7.5% for glucose intolerance. When the new American Diabetes Association Criteria were used, prevalence of type 2 diabetes was 8.8 (CI: 95%: 7.3% to 10.2%) and that of fasting hyperglycemia was 6.9% (CI: 95%: 5.6 to 8.2). According to these new criteria, among the 66 cases with undiagnosed diabetes, 79% presented with a fasting blood glucose > or =126 mg/dl. CONCLUSION: This relatively high diabetes prevalence calls for an appropriate management and health education, particularly focused on high risk subjects. These results bring the the first detailed prevalence data in an Algerian population.

[Dietary risk factors of nasopharyngeal carcinoma in the Setif area in Algeria]. / Facteurs de risque alimentaires du carcinome du nasopharynx dans la région de Sétif (Algérie).

BACKGROUND: The aim of our work was to identify risk factors specific to populations in our region for primary prevention of risk behaviors, particularly eating habits. METHODS: We conducted a case-control study on dietary factors of nasopharyngeal carcinoma in the Setif area in Algeria. The study included 72 cases and 72 controls matched for age, sex and area of residence. The variables analyzed were identified by an anthropological study. RESULTS: Increased risk of disease was associated with consumption of traditionally preserved foods such as "harissa", pickled fruit and vegetables and dried and salted meat. These factors were commonly found in other endemic areas. Certain products appeared to be specific to the Setif area including dried and salted fat, especially after prolonged exposure. Rancid butter was related to a 4 to 7-fold increase in risk and use of pickling increased the risk of nasopharyngeal carcinoma 4 to 12-fold depending on the type of food. CONCLUSIONS: These data point to the need for biochemical analysis of food specimens to search for the carcinogenic agents and to the importance of an immediate information and education program on food habits for the populations living in this area.

Donnees sur l'incidence et la survie du registre du cancer de Setif

Les registres des cancers constituent de plus en plus une source majeure d'information sur le profil de cette maladie dans une localite donnee. Ici a ete appliquee la technique; qui est d'ailleurs clairement expliquee; de recolte des informations pour editer le registre des cancers de Serif en Algerie. Les auteurs ont principalement insiste sur l'incidence et la survie. Chez l'homme le taux le plus eleve concerne les cancers bronchopulmonaires (18;3) et chez les femmes les cancers du sein avec 18;8

[Incidence of cancer in the wilaya of Setif, Algeria]. / Incidence du cancer dans la wilaya de Sétif, Algérie.

Preliminary results are presented for a general population-based cancer registry in Setif, Algeria, for 1986-88. Standardised incidence rates for all sites, excluding non-melanoma skin cancer, are 70.1 for men and 59.9 for women: these rates are lower than those reported for most populations. The most frequent cancers are lung, stomach and liver in men, and cervix, liver and breast in women. Nasopharyngeal carcinoma is frequent in both sexes. Incidence of cancers of the gallbladder and extrahepatic bile ducts in women appears particularly high. These results represent the first detailed incidence data for all cancers in an Algerian population.

Microflora of the nasopharynx in Caucasian and Maghrebian subjects with and without nasopharyngeal carcinoma.

The possible role of bacteria in the etiology of nasopharyngeal carcinoma (NPC) was studied by bacteriological and biochemical analyses of nasopharyngeal swabs collected in the cavum and in the fossa of Rosenmüller of NPC patients and healthy controls in France and Algeria. Counts of total bacteria and of total nitrate-reducing bacteria, mainly enterobacteria, were higher in the Maghrebians than in the Caucasians. The composition of the bacterial flora was different: in Maghrebians, enterobacteria were present in five of 17 control subjects and eight of 15 NPC patients, while the prevalence was only one out of 15 control subjects in Caucasians. Twelve of 32 bacterial species isolated from Caucasians and Maghrebians with normal or tumorous nasopharyngeal microflora were able to catalyse nitrosation of morpholine in vitro. This result suggests that colonization of the nasopharynx by microflora that contain nitrate-reducing microorganisms which can form N-nitroso compounds might represent a risk factor for NPC in Maghrebian populations.

[Evaluation of tobacco consumption in grade school in Wilaya de Sétif]. / Evaluation de la consommation du tabac dans le monde scolaire dans la Wilaya de Setif.

As most developing countries, Algeria does not seem to have escaped the tobacco epidemic raging around the world. Tobacco there has become one of the principal causes of death and illness. To confront this alarming situation, preventive measures have been taken. In particular, an epidemiological investigation of tobacco consumption was conducted among grade-school students in the Wilaya de Setif during the 1986-87 academic year. The fundamental data on tobacco dependency in grade school was obtained. 1,771 students from 12 to 20 years of age were polled through individual and anonymous questionnaires. The dimensions of this scourge were thus revealed: 18% of these students are smokers. The majority (97%) are boys. Smoking begins early, after age 10, with a high point at 14. To face this situation, a National Committee Against Tobacco was introduced by the Ministry of Public Health. A grade school programme is in the planning. The following proposals were made: to inform, widely and objectively, the grade-school population, the teachers and the parents; to take action above all in the primary schools, which constitute an ideal setting to reach these children, who are potential smokers, before they become long-term smokers.