A Hotbed for Liver Cancer: Biomedicine, Exposure and Uncertainty in West Africa

The incidence of primary liver cancer varies strikingly across the globe. West Africans are among those most likely to develop and die from liver cancer. Why? This project first traces the emergence of current biomedical knowledge of risk factors, especially through research in Senegal and The Gambia, and uncovers prior and alternative explanations for why West Africa is a "hotbed" for liver cancer. It then examines past practices and current planning of Senegalese state control of Hepatitis B infection (HBV) and aflatoxins, widely accepted as being responsible for most West African cases of liver cancer. Finally, it describes how liver cancer patients have been cared for amid limited capacity for diagnosis and treatment. Combining history and anthropology, this project delineates, and explores the determinants of, the partial protections against liver cancer deployed by biomedical research, by public immunization, agricultural and regulatory services, and by healthcare in Senegal and The Gambia.