Hepatocellular carcinoma and aflatoxin exposure in Zhuqing Village, Fusui County, People's Republic of China

Hepatocellular carcinoma (HCC) is a common cause of cancer morbidity and mo rtality in Asia and Africa. Epidemiological studies have found that dietary exposure to aflatoxin B-1 (AFB(1)) and chronic infection with hepatitis B virus are two major risk factors for HCC, We have collated the incidence an d mortality data of malignant tumors from 1973 to 1999 in Zhuqing Village, Fusui County, an area with very high HCC rates, and found that this cancer accounted for 64% of the total cancer incidence. Dietary intake of AFB(1) w as monitored for 1 week in a study group consisting of 15 males and 14 fema les from different households in this village. Four of 29 participants (13. 8%) and 3 of 15 (20%) male participants were hepatitis B virus surface anti gen positive. AFB(1) was detectable in 76.7% (23 of 30) of ground corn samp les (range, 0.4-128.1 ppb), 66.7% (20 of 30) of cooking peanut oil samples (range, 0.1-52.5 ppb), and 23.3% (7 of 30) of rice samples (range, 0.3-2.0 ppb) collected from each household. Mean levels of serum AFB(1)-albumin add ucts in this group were 1.24 +/- 0.31 pmol/mg of albumin at the beginning o f the study and 1.21 +/- 0.19 pmol/mg of albumin at the end of the period. Urinary AFB(1) metabolites were detectable in 88.9% (24 of 27) samples (ran ge, 0.9-3569.7 ng/24-h urine), These data provide the exposure and disease risk information for establishing intervention studies to diminish the impa ct of aflatoxin exposure in this high-risk population.