Vanida ChokvanichpongAumpai SarakhanSuleeporn Sangrajrang2011-02-222011-02-222011-01-242011-01-24Thai Cancer Journal; Vol.29 No.4 October-December 2009; 162-175http://imsear.searo.who.int/handle/123456789/132372Cholangiocarcinoma (CCA) is one of the most common cancers in northeastern Thailand, especially Udon Thani Province. The major cause of CCA has been associated with infestation by the liver fluke Opisthorchis viverrini (OV). In northeast Thailand, the tradition of eating raw freshwater fish daily exposes the local population repeatedly to liver-fluke infection. Although the government campaign warns "Do not eat raw fish", the incidence rate is still high in Thailand. The objective of this study was to evaluate behaviors and attitudes in the Udon Thani population related to eating raw freshwater fish. A total of 968 subjects (age range: 15-80 years; mean age: 46 years) were recruited, comprising 659 subjects from Nonghan District and 309 from Khukaw District. A trained interviewer interviewed each participant, and stool samples were collected for laboratory examination. The results indicated that 59.0% of the subjects knew that eating raw freshwater fish was a cause of opisthorchiasis, but a significant proportion did not realize this behavior could result in cholangiocarcinoma (19.9%). Most of the subjects thought that eating raw freshwater fish occasionally (29.8%), or eating a small amount (22.9%), were not risk factors for OV infection. The results showed that the subjects had misunderstandings about opisthorchiasis and cholangiocarcinoma. Therefore, encouraging people to avoid eating raw fish should be undertaken more rigorously, such as by promoting knowledge of the negative effects of eating raw freshwater fish, and supporting local communities to find ways to change eating behaviors. (Thai Cancer J 2009;29:162-175.)en-USNational Cancer Institute of Thailand, Bangkok, ThailandResearch Articles