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. 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

Yan Liu  1 , Felicia Wu
Affiliations

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

Yan Liu et al. Environ Health Perspect. 2010 Jun.

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.

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Figures

Figure 1
Figure 1
Distribution of HCC cases attributable to aflatoxin in different regions of the world.
See this image and copyright information in PMC

Comment in

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