Premium
Aflatoxin exposure and risk of hepatocellular carcinoma in Taiwan
Author(s) -
Wang LiYu,
Hatch Maureen,
Chen ChienJen,
Levin Bruce,
You SanLin,
Lu ShengNan,
Wu MeiHuei,
Wu WeiPin,
Wang LianWen,
Wang Qiao,
Huang GuanTarn,
Yang PeiMing,
Lee HsuanShu,
Santella Regina M.
Publication year - 1996
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/(sici)1097-0215(19960904)67:5<620::aid-ijc5>3.0.co;2-w
Subject(s) - aflatoxin , hbsag , hepatocellular carcinoma , medicine , serostatus , hepatitis b virus , carcinogen , hepatitis b , odds ratio , urine , physiology , gastroenterology , immunology , biology , food science , viral load , virus , biochemistry
To investigate the carcinogenic effect of environmental aflatoxin exposure, 56 cases of hepatocellular carcinoma (HCC) diagnosed between 1991 and 1995 were identified and individually matched by age, sex, residence and date of recruitment to 220 healthy controls from the same large cohort in Taiwan. Blood samples were analyzed for hepatitis B and C viral markers and for aflatoxin‐albumin adducts; urine was tested for aflatoxin metabolites. We obtained information about socio‐demographic characteristics, habitual alcohol drinking, cigarette smoking and diet in a structured interview. Hepatitis B virus surface antigen (HBsAg) carriers had a significantly increased risk for HCC. After adjustment for HBsAg serostatus, the matched odds ratio (OR m ) was significantly elevated for subjects with high levels of urinary aflatoxin metabolites. When stratified into tertiles, a dose‐response relationship with HCC was observed. The OR m for detectable aflatoxin‐albumin adducts was not significant after adjustment for HBsAg serostatus. HBsAg‐seropositive subjects with high aflatoxin exposure had a higher risk than subjects with high aflatoxin exposure only or HBsAg seropositivity only. In male HBsAg‐seropositive subjects, adjusted ORs were 2.8 (95% confidence interval [Cl] = 0.9–9.1) for detectable compared with non‐detectable aflatoxin‐albumin adducts and 5.5 (Cl = 1.3–23.4) for high compared with low urinary aflatoxin metabolite levels. Our results suggest that environmental aflatoxin exposure may enhance the hepatic carcinogenic potential of hepatitis B virus. A large‐scale study will be needed to evaluate the effect of aflatoxin exposure on HBsAg non‐carriers. © 1996 Wiley‐Liss, Inc.