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Environ Health Perspect. 2010 Jun;118(6):818-24. doi: 10.1289/ehp.0901388. Epub 2010 Feb 19.

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

Author information

1
Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15219 , USA.

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.

PMID:
20172840
PMCID:
PMC2898859
DOI:
10.1289/ehp.0901388
[Indexed for MEDLINE]
Free PMC Article

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