The Role of Aflatoxins in Hepatocellular Carcinoma

Context: hepatocellular carcinoma (hcc) is one of the most common cancers in the world but with a striking geographical variation in incidence; most of the burden is in developing countries. this geographic variation in hcc incidence might be due to geographic differences in the prevalence of various etiological factors. evidence acquisition: here, we review the epidemiological evidence linking dietary exposure to aflatoxin b1 (afb1) and risk of hcc, possible interactions between afb1 and hepatitis b virus (hbv) or polymorphisms of genes involved in afb1-related metabolism as well as dna repair. results: ecological, case-control and cohort studies that used various measures of aflatoxin exposure including dietary questionnaires, food surveys and biomarkers are summarized. conclusions: taken together, the data suggest that dietary exposure to aflatoxins is an important contributor to the high incidence of hcc in asia and sub-saharan africa, where almost 82% of the cases occur.