The case for aflatoxins in the causal chain of gallbladder cancer

Medical Hypotheses
Claudia FoersterCatterina Ferreccio

Abstract

Chronic aflatoxin exposure has long been related to hepatocellular carcinoma (HCC). Recently, its association with gallbladder cancer (GBC) was postulated. Here we present the data supporting this hypothesis in Chile, the country with the highest GBC mortality worldwide with age-standardized mortality rates (ASMR) of 10.3 in women and 5.04 in men. The highest GBC rates occur in Southern Chile (ASMR=18), characterized by: high Amerindian ancestry, associated with high bile acid synthesis and gallstones; high poverty and high cereal agriculture, both associated with aflatoxin exposure. Aflatoxins have been detected in imported and locally grown foods items. We estimated population dietary exposure ranging from 0.25 to 35.0 ng/kg-body weight/day. The only report on human exposure in Chile found significantly more aflatoxin biomarkers in GBC than in controls (Odds Ratio=13.0). The hypothesis of aflatoxin-GBC causal link in the Chilean population is supported by: genetically-determined rapid cholesterol excretion and high gallstones prevalence (49.4%); low prevalence of HCC (ASMR=4.9) and low HBV infection (0.15%) the main co-factor of aflatoxins in HCC risk. If the association between aflatoxins and GBC were confirmed, public healt...Continue Reading

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Citations

Feb 1, 2017·Journal of Surgical Oncology·Chandrakanth AreSanjib Chowdhury
Apr 22, 2017·Gastroenterology·Jill KoshiolJohn Groopman
Jul 30, 2019·Mycotoxin Research·Claudia FoersterGisela Rios
May 22, 2021·Mycotoxin Research·Jéssica CostaCledir Santos
Jul 17, 2021·Seminars in Cancer Biology·Prabodh Chander SharmaRamesh K Goyal

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