Global Burden of Aflatoxin-Induced Hepatocellular Carcinoma: A Risk Assessment

By Yan Liu, Felicia Wu. Environmental Health Perspectives, 2010

1,188 citations recorded by the source corpus.

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.

Subfields: Food Science, Health, Toxicology and Mutagenesis, Plant Science

View Paper: https://www.semanticscholar.org/paper/26c22952f6dc412265ff025389ed6fb055faa889

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Citations in the corpus

Field efficacy of a mixture of atoxigenic Aspergillus flavus Link:Fr vegetative compatibility groups in preventing aflatoxin contamination in maize (Zea mays L.) (2014, background): “In addition to being potent hepatotoxic and carcinogenic metabolites (Liu and Wu, 2010), aflatoxins suppress the immune system increasing susceptibility of humans to infections and also retard growth and development in young children (Jolly et al., 2008; Khlangwiset et al., 2011).”
Hepatocellular carcinoma: a review (2016, background): “with chronic hepatitis B plus aflatoxin exposure than with aflatoxin exposure alone.(45) The most potent aflatoxin, AFB1, when removed from the environment has resulted in a reduction of the incidence of HCC.”
Occurrence, Toxicity, and Analysis of Major Mycotoxins in Food (2017, background): “parasiticus that are present normally in soil and various organic materials [14,26].”
Aflatoxin: a 50-year odyssey of mechanistic and translational toxicology. (2011, background): “Recently Liu and Wu (2010) have developed a risk assessment for the contribution of aflatoxin to the global burden of HCC.”
Biological control of aflatoxins in Africa: current status and potential challenges in the face of climate change (2016, positive): “…effects, such as liver cirrhosis and death (CDC, 2004; Probst et al. , 2007), while sub-lethal chronic exposure may cause cancer and is associated with stunting in children, immune system suppression, and impaired food conversion (Bhat et al. , 2010; Chan-Hon-Tong et al. , 2013; Liu and Wu, 2010).”
Global epidemiology of hepatocellular carcinoma: an emphasis on demographic and regional variability (2015, background): “A recent examination of the population attributable risk of AFB1 in high rate areas reported that between 8.8% and 21% of liver cancer could be attributed to AFB1.”
Post-harvest management of aflatoxin contamination in groundnut (2015, background): “Most of these are in SSA, Southeast Asia, and China and are caused by uncontrolled aflatoxin accumulation in food and hepatitis B virus infection (Liu and Wu, 2010).”