Hepatocarcinogenesis Induced by Environmental Exposures in the Middle East

The incidence of hepatocellular carcinoma (HCC) has been rising in the Middle East. Liver cancer is a major concern, particularly in Egypt. Although hepatitis infections are suggested to be the main causes of HCC, environmental exposures also contribute to high morbidity and mortality rates of this disease. Aflatoxins are one of the main causes of HCC. Aflatoxin B1 is classified as a “human carcinogen,” and it can contribute to the increasing incidence of HCC in the Middle East countries. In hepatitis patients, aflatoxin exposure is a major risk factor for primary liver cancers. Alcohol consumption and smoking can also lead to HCC. Moreover, exposure to arsenic and certain chemicals, particularly to vinyl chloride, may also be an underlying factor for HCC. This chapter will focus on environmental carcinogenesis in the Middle East, their mechanism of action, and studies performed in Middle East on aflatoxins, alcohol, smoking, arsenic, and vinyl chloride.