Aflatoxin and liver cancer

This chapter reviews the data that have been accumulated implicating aflato xin ingestion as an important risk factor in the aetiology of hepatocellula r carcinoma (HCC). Numerous epidemiological studies have observed a correla tion between areas of high aflatoxin exposure and a high incidence of HCC. The use of experimental models and specific biomarkers for aflatoxin exposu re, such as urinary metabolites or aflatoxin adducts, have validated these findings. Ongoing clinical trials in Qidong, China, have indicated that olt ipraz, a chemopreventive agent, can lower the biologically effective dose o f aflatoxins by decreasing the metabolism of aflatoxin to its carcinogenic form and increasing the detoxification pathways of these metabolites. Inter vention with chemicals such as these, alongside hepatitis B virus immunizat ion programmes and improved storage conditions of staple foods, are prevent ion measures that can be undertaken to reduce the incidence of HCC in high- risk regions.