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Raw fish dishes could give you liver cancer


You may think eating traditional dishes when you go abroad is custom – but you should think twice before doing so in Thailand.

Koi pla, made of raw fish ground with spices and lime, is a favourite feast for parasites responsible for deadly liver cancer, doctors warn. The pungent meal is quick, cheap and tasty, and is popular in the rural northeast of the country – in the poor remote Isaan region.

But this area of Thailand, deemed the least-visited, has the highest reported cases of cholangiocarcinoma (CCG) bile duct cancer in the world, figures show.


One of the major causes of CCG, which kills 20,000 Thais each year, is a parasitic flatworm native to the Mekong region and found in freshwater fish. Once eaten, the worms can embed undetected in the bile ducts for years causing inflammation that triggers the deadly disease, the World Health Organization warns. Narong Khuntikeo, a liver surgeon trying to battle the parasitic scourge, witnessed both of his koi pla-loving parents die from CCG.

He told AFP: “It’s a very big health burden around here… it affects families, education and socioeconomic development. But nobody knows about this because they die quietly, like leaves falling from a tree.”

After seeing hundreds of hopeless late-stage cases on the operating table, Narong is now marshalling scientists to attack the ‘silent killer’ at source. They are fanning out across Isaan provinces to screen villagers for the liver fluke and warn them of the perils of koi pla and other risky fish dishes.

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