Global burden of aflatoxin-induced hepatocellular carcinoma: a risk assessment.

Abstract:

BACKGROUND:Hepatocellular carcinoma (HCC), or liver cancer, is the third leading cause of cancer deaths worldwide, with prevalence 16-32 times higher in developing countries than in developed countries. Aflatoxin, a contaminant produced by the fungi Aspergillus flavus and Aspergillus parasiticus in maize and nuts, is a known human liver carcinogen. OBJECTIVES:We sought to determine the global burden of HCC attributable to aflatoxin exposure. METHODS:We conducted a quantitative cancer risk assessment, for which we collected global data on food-borne aflatoxin levels, consumption of aflatoxin-contaminated foods, and hepatitis B virus (HBV) prevalence. We calculated the cancer potency of aflatoxin for HBV-postive and HBV-negative individuals, as well as the uncertainty in all variables, to estimate the global burden of aflatoxin-related HCC. RESULTS:Of the 550,000-600,000 new HCC cases worldwide each year, about 25,200-155,000 may be attributable to aflatoxin exposure. Most cases occur in sub-Saharan Africa, Southeast Asia, and China where populations suffer from both high HBV prevalence and largely uncontrolled aflatoxin exposure in food. CONCLUSIONS:Aflatoxin may play a causative role in 4.6-28.2% of all global HCC cases.

authors

Liu Y,Wu F

doi

10.1289/ehp.0901388

subject

Has Abstract

pub_date

2010-06-01 00:00:00

pages

818-24

issue

6

eissn

0091-6765

issn

1552-9924

journal_volume

118

pub_type

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